Individual
DR. HASUMATI VIJAYKUMAR MEHTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
518 SANDHURST DR, FAYETTEVILLE, NC 28304-4426
(910) 323-4091
(910) 323-4092
Mailing address
PO BOX 87169, FAYETTEVILLE, NC 28304-7169
(910) 323-4091
(910) 323-4092
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20167
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02145
BCBS GROUP NUMBER
NC
01
—
208795
PTAN
NC
05
—
8958493
—
NC
Enumeration date
03/15/2006
Last updated
11/04/2011
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