Provider Demographics
NPI:1730280074
Name:MEHTA, INDER D (MD)
Entity type:Individual
Prefix:
First Name:INDER
Middle Name:D
Last Name:MEHTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2419
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:601-926-4978
Practice Address - Street 1:1514 JEFFERSON HIGHWAY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2419
Practice Address - Country:US
Practice Address - Phone:504-842-3966
Practice Address - Fax:601-926-4978
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS18646208G00000X
LAMD.205156208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS02329849Medicaid
LA2178270Medicaid
G42185Medicare UPIN
LA2178270Medicaid
MS330000036Medicare ID - Type Unspecified
MS512I330001Medicare PIN