# MEHTA MEDICINE GROUP LLC

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

## Provider details

- **NPI number:** 1992372320
- **Authorized official:** SUDEEP MEHTA MD (OWNER)
- **Authorized official phone:** (704) 787-4537

## Contact information

- **Practice address:** 2475 HILLCREST CENTER CIR, WINSTON SALEM, NC 27103-3048
- **Practice address phone:** (704) 787-4537
- **Mailing address:** 1543 HEATHER GLEN RD, KANNAPOLIS, NC 28081-6410
- **Mailing address phone:** (704) 787-4537

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/04/2021
- **Last updated:** 06/04/2021