Individual
GAURAV MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3700 JOSEPH SIEWICK DR STE 106, FAIRFAX, VA 22033-1737
(571) 724-4400
Mailing address
224- D CORNWALL STREET, NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101285584
VA
207Q00000X
Family Medicine Physician
125060123
IL
207Q00000X
Family Medicine Physician
C1-0011080
DE
207QB0002X
Obesity Medicine (Family Medicine) Physician
0101285584
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30018458540001
—
VA
Enumeration date
08/06/2010
Last updated
03/24/2026
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