Provider Demographics
NPI:1134408776
Name:GANDHI MEHTA, RACHANA KAUSHAL (MD)
Entity type:Individual
Prefix:MRS
First Name:RACHANA
Middle Name:KAUSHAL
Last Name:GANDHI MEHTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHANA
Other - Middle Name:BHARATKUMAR
Other - Last Name:GANDHI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:DUMC 3403
Mailing Address - Street 2:DUKE UNIVERSITY MEDICAL CENTER, NEUROMUSCULAR DEPARTMEN
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710
Mailing Address - Country:US
Mailing Address - Phone:240-988-4666
Mailing Address - Fax:
Practice Address - Street 1:MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27157-0001
Practice Address - Country:US
Practice Address - Phone:336-716-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2015-016222084N0400X
FLTRN#15985207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine