Provider Demographics
NPI:1639108723
Name:MEHTA, URVASHI HARESH (MD)
Entity Type:Individual
Prefix:
First Name:URVASHI
Middle Name:HARESH
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:PO BOX 601643
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-1643
Mailing Address - Country:US
Mailing Address - Phone:704-993-2240
Mailing Address - Fax:704-993-2244
Practice Address - Street 1:600 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NC
Practice Address - Zip Code:28112-6000
Practice Address - Country:US
Practice Address - Phone:704-993-2240
Practice Address - Fax:704-993-2244
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27930207R00000X
NC200601119207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC279308Medicaid
NC5903525Medicaid
NCNC9797CMedicare PIN
SC7762Medicare PIN
SC279308Medicaid
NC2073508Medicare PIN