Provider Demographics
NPI:1346295490
Name:MEHTA, NALINI K (MD)
Entity Type:Individual
Prefix:
First Name:NALINI
Middle Name:K
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1717 BIDDLE ST
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63106-3454
Mailing Address - Country:US
Mailing Address - Phone:314-814-8531
Mailing Address - Fax:314-814-8542
Practice Address - Street 1:2220 LEMP AVE
Practice Address - Street 2:SOULARD BENTON HEALTH CENTER
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-2700
Practice Address - Country:US
Practice Address - Phone:314-814-8531
Practice Address - Fax:314-814-8542
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2016-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR3G84207P00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO208481119Medicaid
MO208481119Medicaid