Provider Demographics
NPI:1992047617
Name:MEHTA, VIRAJ JAYESH (MD, MBA)
Entity type:Individual
Prefix:DR
First Name:VIRAJ
Middle Name:JAYESH
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8138 WATSON ST
Mailing Address - Street 2:
Mailing Address - City:MC LEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22102-4416
Mailing Address - Country:US
Mailing Address - Phone:703-827-5454
Mailing Address - Fax:
Practice Address - Street 1:8138 WATSON ST
Practice Address - Street 2:
Practice Address - City:MC LEAN
Practice Address - State:VA
Practice Address - Zip Code:22102-4416
Practice Address - Country:US
Practice Address - Phone:703-827-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0087530207W00000X, 207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology