Provider Demographics
NPI:1093126286
Name:MEJIA, ARTURO (SA-C)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:MEJIA
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 NORTHCLIFFE DR
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3024
Mailing Address - Country:US
Mailing Address - Phone:301-520-1454
Mailing Address - Fax:
Practice Address - Street 1:630 NORTHCLIFFE DR
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3024
Practice Address - Country:US
Practice Address - Phone:301-520-1454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-10
Last Update Date:2014-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12-199246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant