Individual
PRAVEEN MEHROTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
925 CHESTNUT ST, MEZZANINE, PHILADELPHIA, PA 19107-4216
(215) 955-5050
Mailing address
925 CHESTNUT ST, MEZZANINE, PHILADELPHIA, PA 19107-4216
(215) 955-5050
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD446086
PA
207RC0000X
Cardiovascular Disease Physician
Primary
MD446086
PA
390200000X
Student in an Organized Health Care Education/Training Program
232211
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0309273
—
NJ
05
—
102740178
—
PA
Enumeration date
03/26/2008
Last updated
11/09/2012
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