Individual
DR. NIMISH MEHTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 PENNSYLVANIA AVE, CHARLESTON, WV 25302-3351
(304) 388-2550
Mailing address
3100 MACCORKLE AVE SE, STE 203, CHARLESTON, WV 25304-1228
(304) 388-1724
(304) 388-1721
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
20051
WV
208000000X
Pediatrics Physician
20051
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001718074
WV BCBS
WV
01
—
1057343
WV DWC
WV
05
—
1803190000
—
WV
Enumeration date
12/28/2005
Last updated
04/28/2023
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