Provider Demographics
NPI:1962437475
Name:MEHRA, SHVETA (MD)
Entity type:Individual
Prefix:DR
First Name:SHVETA
Middle Name:
Last Name:MEHRA
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 1:1760 E RIVER RD STE 350
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5999
Mailing Address - Country:US
Mailing Address - Phone:520-519-7775
Mailing Address - Fax:
Practice Address - Street 1:2538 E UNIVERSITY DR
Practice Address - Street 2:STE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85034-6925
Practice Address - Country:US
Practice Address - Phone:623-806-1500
Practice Address - Fax:623-433-0174
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35116207ZP0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ113438Medicaid
AZ113438Medicaid
AZZ158940Medicare PIN
AZZ144491Medicare PIN
AZZ145852Medicare PIN