Provider Demographics
NPI:1629365283
Name:MEHTA, ANAND PRAVIN (MD)
Entity type:Individual
Prefix:DR
First Name:ANAND
Middle Name:PRAVIN
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3535 ROSWELL RD STE 15
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-6252
Mailing Address - Country:US
Mailing Address - Phone:770-274-4435
Mailing Address - Fax:470-300-8895
Practice Address - Street 1:3535 ROSWELL RD STE 15
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-6252
Practice Address - Country:US
Practice Address - Phone:770-274-4435
Practice Address - Fax:470-300-8895
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2024-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA08963000207Q00000X
GA71759207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine