Provider Demographics
NPI:1215084975
Name:MEHTA, PRIYADARSHINI KUMARAN (MD)
Entity type:Individual
Prefix:DR
First Name:PRIYADARSHINI
Middle Name:KUMARAN
Last Name:MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:PRIYA
Other - Middle Name:K
Other - Last Name:MEHTA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:15 SCOTTS MOOR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-5803
Mailing Address - Country:US
Mailing Address - Phone:864-288-6245
Mailing Address - Fax:
Practice Address - Street 1:111A BERRY AVE
Practice Address - Street 2:
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29651-1307
Practice Address - Country:US
Practice Address - Phone:864-801-2035
Practice Address - Fax:864-801-2037
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17359207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine