Provider Demographics
NPI:1154530277
Name:MOHEY, MEGHA (MD)
Entity type:Individual
Prefix:DR
First Name:MEGHA
Middle Name:
Last Name:MOHEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14752 NORTHLINE RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-2698
Mailing Address - Country:US
Mailing Address - Phone:734-785-6003
Mailing Address - Fax:734-985-2333
Practice Address - Street 1:14752 NORTHLINE RD
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-2698
Practice Address - Country:US
Practice Address - Phone:734-785-6003
Practice Address - Fax:734-985-2333
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301085682207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1154530277Medicaid
MIMI14722001OtherMEDICARE