Individual
RENU M. MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
900 FAIRDALE RD, FAIRDALE, KY 40118-9731
(502) 366-8778
(502) 366-9163
Mailing address
6801 DIXIE HWY, STE 130, LOUISVILLE, KY 40258-3913
(502) 366-8778
(502) 366-9163
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35332
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64009764
—
KY
Enumeration date
05/27/2006
Last updated
04/04/2013
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