Provider Demographics
NPI:1932250008
Name:JADEJA, MAHENDRASINH A (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHENDRASINH
Middle Name:A
Last Name:JADEJA
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 1:135 EAST 38TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16504
Mailing Address - Country:US
Mailing Address - Phone:814-860-2358
Mailing Address - Fax:814-860-2356
Practice Address - Street 1:135 EAST 38TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16504
Practice Address - Country:US
Practice Address - Phone:814-860-2358
Practice Address - Fax:814-860-2356
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2009-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL993878207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine