Provider Demographics
NPI:1326262635
Name:MEHTA, NARESH CHANDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:NARESH
Middle Name:CHANDRA
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BLUEGRASS LN
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-4201
Mailing Address - Country:US
Mailing Address - Phone:508-792-1903
Mailing Address - Fax:
Practice Address - Street 1:14 BLUEGRASS LANE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-4201
Practice Address - Country:US
Practice Address - Phone:508-792-1903
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA726322080H0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080H0002XAllopathic & Osteopathic PhysiciansPediatricsHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3071324Medicaid
MAJ12051Medicare ID - Type Unspecified
MAF16710Medicare UPIN