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Individual

DR. PANKAJ G MEHTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
777 RURAL AVE, WILLIAMSPORT, PA 17701-3109
(570) 323-3671
(570) 321-0648
Mailing address
1201 GRAMPIAN BLVD, SUITE 1K, WILLIAMSPORT, PA 17701-1900

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
MD038224L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000093059
PA BS
PA
05
0007584200002
PA
01
160054367
RR MEDICARE
PA
01
19810-7573
GHP
PA
01
72703
FIRST PRIORITY HMO
PW
01
C29646
HEALTH AMMERICA
PA
Enumeration date
10/12/2005
Last updated
10/21/2011
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