Provider Demographics
NPI:1922067396
Name:MEHTA, AMISH M (MD)
Entity Type:Individual
Prefix:
First Name:AMISH
Middle Name:M
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:575 COAL VALLEY RD
Mailing Address - Street 2:SUITE 570
Mailing Address - City:JEFFERSON HILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15025-3730
Mailing Address - Country:US
Mailing Address - Phone:412-469-7660
Mailing Address - Fax:412-469-7547
Practice Address - Street 1:575 COAL VALLEY RD STE 570
Practice Address - Street 2:
Practice Address - City:JEFFERSON HILLS
Practice Address - State:PA
Practice Address - Zip Code:15025-3729
Practice Address - Country:US
Practice Address - Phone:412-469-7660
Practice Address - Fax:412-469-7547
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD068396L207RC0000X
PAMD068397L207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1816027Medicaid
OH2691494Medicaid
WV3810006922Medicaid
PA0018160270003Medicaid
WV3810006922Medicaid
PA1816027Medicaid
PAP00440493Medicare PIN
OH2691494Medicaid