Provider Demographics
NPI:1225148505
Name:MEHTA, SONALI (MD)
Entity Type:Individual
Prefix:
First Name:SONALI
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3045 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3770
Mailing Address - Country:US
Mailing Address - Phone:304-723-4000
Mailing Address - Fax:304-794-7100
Practice Address - Street 1:3 ROBINSON PLZ
Practice Address - Street 2:SUITE 100
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15205-1024
Practice Address - Country:US
Practice Address - Phone:304-723-4000
Practice Address - Fax:304-794-7100
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4357722080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4700052Medicaid
PA1024310650002Medicaid