Provider Demographics
NPI:1922493196
Name:MEHTA, RITESH JAYESH (MD,)
Entity Type:Individual
Prefix:DR
First Name:RITESH
Middle Name:JAYESH
Last Name:MEHTA
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 1:11 CHARLEY HARPER DR SE STE 100
Mailing Address - Street 2:
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-1123
Mailing Address - Country:US
Mailing Address - Phone:678-719-0087
Mailing Address - Fax:
Practice Address - Street 1:11 CHARLEY HARPER DR SE STE 100
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-1123
Practice Address - Country:US
Practice Address - Phone:678-719-0087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-03
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA859472083X0100X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program