Individual
NISHAKI MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3601 W 13 MILE RD, ROYAL OAK, MI 48073-6712
(248) 898-4163
(248) 898-5596
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
240442
MA
207RC0000X
Cardiovascular Disease Physician
0101263584
VA
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
4301501853
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417182544
—
VA
Enumeration date
05/19/2009
Last updated
07/29/2022
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