Provider Demographics
NPI:1669471348
Name:MEHTA, ASHU P (MD)
Entity Type:Individual
Prefix:DR
First Name:ASHU
Middle Name:P
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 37168
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3168
Mailing Address - Country:US
Mailing Address - Phone:443-292-4872
Mailing Address - Fax:443-292-4892
Practice Address - Street 1:1655 CROFTON BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:CROFTON
Practice Address - State:MD
Practice Address - Zip Code:21114-1342
Practice Address - Country:US
Practice Address - Phone:443-292-4872
Practice Address - Fax:443-292-4892
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0060213207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00206049OtherRR MEDICARE
MD409668100Medicaid
P00206049OtherRR MEDICARE
MD409668100Medicaid
MD145PMedicare PIN