Provider Demographics
NPI:1831301480
Name:MEHRA, MOHIT (MD)
Entity Type:Individual
Prefix:
First Name:MOHIT
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 1:100 PILOT MEDICAL DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3411
Mailing Address - Country:US
Mailing Address - Phone:205-854-8404
Mailing Address - Fax:205-854-4302
Practice Address - Street 1:100 PILOT MEDICAL DR
Practice Address - Street 2:SUITE 225
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3411
Practice Address - Country:US
Practice Address - Phone:205-854-8404
Practice Address - Fax:205-854-4302
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007013695207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1021934364Medicare PIN