Individual
PRADIP M MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 ELMWOOD PARK DR, DAYTON, OH 45449-5402
(937) 384-0580
Mailing address
100 ELMWOOD PARK DR, DAYTON, OH 45449-5402
(937) 384-0580
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
35.123682
OH
207LP2900X
Pain Medicine (Anesthesiology) Physician
35.123682
OH
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
35.123682
OH
208VP0000X
Pain Medicine Physician
35.123682
OH
208VP0014X
Interventional Pain Medicine Physician
35.123682
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2840804
—
OH
Enumeration date
11/18/2005
Last updated
11/28/2018
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