Individual
SHAILEN K. MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 441-8070
(740) 446-5408
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 441-8070
(740) 446-5408
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
18701
WV
208100000X
Physical Medicine & Rehabilitation Physician
Primary
35-06-7511
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007362
ANTHEM BCBS
—
01
—
000000185212
UNISON MEDICAID
OH
01
—
001714069
MOUNTAIN STATE BCBS
—
05
—
0113594000
—
WV
01
—
0995115
MOLINA MEDICAID
OH
01
—
250005225
RR MEDICARE
—
01
—
310917085142
CARESOURCE MEDICAID
OH
Enumeration date
06/02/2006
Last updated
02/06/2015
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