Basic Information
| Provider Information | |||||||||
| NPI: | 1245211655 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEHTA | ||||||||
| FirstName: | APURVA | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 636745 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452636745 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134514033 | ||||||||
| FaxNumber: | 5134514118 | ||||||||
| Practice Location | |||||||||
| Address1: | 5520 CHEVIOT ROAD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45247 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5134514033 | ||||||||
| FaxNumber: | 5134514033 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/11/2005 | ||||||||
| LastUpdateDate: | 05/16/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35.081652 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0003X | 37440 | KY | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | 207RH0003X | 35.081652 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
ID Information
| ID | Type | State | Issuer | Description | 2694197 | 05 | OH | MEDICAID | 200464300 | 05 | IN | MEDICAID | 64083413 | 05 | KY | MEDICAID |