Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 30618 | SC |
Y | 207RX0202X | Medical Oncology | 30618 | SC |
NPI | 1447371281 |
---|---|
Provider Name | Sharmila Pravin Mehta |
First Address | Greenville, SC 29601-2842 |
Second Address | Greenville, SC 29605-4655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 08/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1447371281 | (05) | SC |
306181 | (05) | SC |
AA2655 | (02) | SC |
AA26554746 | MEDICARE PIN (01) | SC |