Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 4301074752 | MI |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 2014-02192 | NC |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 4301074752 | MI |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | MD457036 | PA |
NPI | 1215982020 |
---|---|
Provider Name | Shobha H Mehta |
First Address | Charlotte, NC 28260-1372 |
Second Address | Charlotte, NC 28204-2968 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 27/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1215982020 | (05) | NC |
492502510 | (05) | MI |
700H262210 | BLUE CROSS-BLUE CROSS (01) | |
I52992 | (02) | |
NC2266 | (05) | SC |
SM074752 | CHAMPUS-CHAMPUS (01) | |
SM074752 | COMMERCIAL-COMMERCIAL NUMBER (01) |