Individual
PRATIMA M MEHTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5825 BROADWAY, SUITE A, MERRILLVILLE, IN 46410-2687
(219) 884-1400
(219) 884-1453
Mailing address
441,SCARBOROUGH ROAD,, VALPARAISO, IN 46385-8008
(219) 465-1834
(219) 548-7061
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
01032516A
IN
207Q00000X
Family Medicine Physician
Primary
01032516A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
247800
GROUP
IN
01
—
247800C
GROUP INDIVIDUAL
IN
Enumeration date
08/05/2006
Last updated
11/26/2014
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