# VIRENDRA S MEHTA MD FRCS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235307380
- **Authorized official:** VIRENDRA SINHA MEHTA MD (PRESIDENT)
- **Authorized official phone:** (248) 842-7913

## Contact information

- **Practice address:** 10000 TELEGRAPH RD, TAYLOR, MI 48180-3330
- **Practice address phone:** (248) 842-7913
- **Practice address fax:** (313) 295-5315
- **Mailing address:** 47493 BLUE HERON CT, NORTHVILLE, MI 48168-8823
- **Mailing address phone:** (248) 842-7913
- **Mailing address fax:** (586) 649-7391

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/12/2008
- **Last updated:** 04/29/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 18790900829350 | — | MI |