Provider Demographics
NPI:1467422279
Name:UNDERINER, ANGELI MEHTA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANGELI
Middle Name:MEHTA
Last Name:UNDERINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4834 SOCIALVILLE FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6826
Mailing Address - Country:US
Mailing Address - Phone:513-398-5960
Mailing Address - Fax:513-459-7833
Practice Address - Street 1:4834 SOCIALVILLE FOSTER RD
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6826
Practice Address - Country:US
Practice Address - Phone:513-398-5960
Practice Address - Fax:513-459-7833
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH080893208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2316649Medicaid
OTH000Medicare UPIN