Provider Demographics
NPI:1497933832
Name:MEHTA, RUBY (MD)
Entity Type:Individual
Prefix:
First Name:RUBY
Middle Name:
Last Name:MEHTA
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 1:4200 WISCONSIN AVE NW STE 2
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2143
Mailing Address - Country:US
Mailing Address - Phone:202-243-3558
Mailing Address - Fax:877-680-5504
Practice Address - Street 1:4200 WISCONSIN AVE NW STE 2
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2143
Practice Address - Country:US
Practice Address - Phone:202-243-3558
Practice Address - Fax:877-680-5504
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010898492080P0206X
GA46962080T0004X
DCMD0436492080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
No2080T0004XAllopathic & Osteopathic PhysiciansPediatricsPediatric Transplant Hepatology