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Individual

JOGINDER PAUL MEHTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
Mailing address
5401 OLD COURT RD, RANDALLSTOWN, MD 21133-5103
(410) 601-5524
(410) 601-8946

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0041410
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
110167461
R/R MEDICARE PROVIDER #
MD
05
785911200
MD
01
CN6601
R/R MEDICARE GROUP #
MD
Enumeration date
04/03/2006
Last updated
10/16/2008
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