Provider Demographics
NPI:1659374700
Name:MEHRA, TARUN (MD)
Entity Type:Individual
Prefix:DR
First Name:TARUN
Middle Name:
Last Name:MEHRA
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 1:1153 E MAIN ST
Mailing Address - Street 2:PO BOX 2563
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-4056
Mailing Address - Country:US
Mailing Address - Phone:740-687-8990
Mailing Address - Fax:740-687-8230
Practice Address - Street 1:1055 W MARKET ST
Practice Address - Street 2:STE H
Practice Address - City:BALTIMORE
Practice Address - State:OH
Practice Address - Zip Code:43105-1283
Practice Address - Country:US
Practice Address - Phone:740-862-0660
Practice Address - Fax:740-862-3704
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35076309207R00000X
OH35076309M207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2207409Medicaid
OH4036983Medicare PIN
INH28038Medicare UPIN