Provider Demographics
NPI:1962621615
Name:MEHTA, AKANKSHA
Entity type:Individual
Prefix:
First Name:AKANKSHA
Middle Name:
Last Name:MEHTA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1365 CLIFTON ROAD
Mailing Address - Street 2:BUILDING B SUITE 1400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322
Mailing Address - Country:US
Mailing Address - Phone:401-444-8450
Mailing Address - Fax:401-444-5088
Practice Address - Street 1:1365 CLIFTON ROAD
Practice Address - Street 2:BUILDING B SUITE 1400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322
Practice Address - Country:US
Practice Address - Phone:404-778-4898
Practice Address - Fax:401-444-5088
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILP00881208800000X
GA070201208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology