Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | D0036206 | MD |
N | 207RS0012X | Sleep Medicine | D0036206 | MD |
NPI | 1275552853 |
---|---|
Provider Name | Kiran Mehta |
First Address | Hollywood, MD 20636-4871 |
Second Address | Hollywood, MD 20636-4871 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 06/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E87132 | (02) | MD |