Provider Demographics
NPI:1902018492
Name:RAJENDRA MEHTA MD INC
Entity Type:Organization
Organization Name:RAJENDRA MEHTA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:PAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-520-3022
Mailing Address - Street 1:PO BOX 39473
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139
Mailing Address - Country:US
Mailing Address - Phone:216-520-3022
Mailing Address - Fax:216-520-3023
Practice Address - Street 1:6701 ROCKSIDE RD
Practice Address - Street 2:#370
Practice Address - City:INDEPENDENCE
Practice Address - State:OH
Practice Address - Zip Code:44131-2358
Practice Address - Country:US
Practice Address - Phone:216-520-3022
Practice Address - Fax:216-520-3023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0702421Medicaid
OH00130605OtherRAILROAD MEDICARE ID
OH110240022OtherRAILROAD MEDICARE ID
OH2141542Medicaid
OH9309911Medicare PIN
OHC03360Medicare UPIN
OHH02716Medicare UPIN
OH00130605OtherRAILROAD MEDICARE ID
OH2141542Medicaid