Provider Information for 1114187614
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VIVEK MUKUR MEHTA MD
Sex: Male
NPI: 1114187614
Last Updated: 2013-06-26
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1114187614 | ||||||||||||
| Enumeration Date | 2008-06-10 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2222 E HIGHLAND AVE SUITE 300 PHOENIX, AZ 85016-4872 United States Phone: 602-277-6211 | Fax:866-242-5309 | ||||||||||||
| Primary Practice Address | 2222 E HIGHLAND AVE SUITE 300 PHOENIX, AZ 85016-4872 United States Phone: 602-277-6211 | Fax:866-242-5309 | ||||||||||||
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