Individual
SANJAY RASIK MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
340 PEPPERS FERRY RD, WYTHEVILLE, VA 24382-2091
(276) 250-1675
(206) 203-0141
Mailing address
340 PEPPERS FERRY RD, WYTHEVILLE, VA 24382-2091
(276) 250-1675
(206) 203-0141
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0102202805
VA
207R00000X
Internal Medicine Physician
254
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6000748000
—
WV
Enumeration date
08/12/2005
Last updated
10/07/2015
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