1134408776 NPI number — MRS. RACHANA KAUSHAL GANDHI MEHTA M.D.

Table of content: MRS. RACHANA KAUSHAL GANDHI MEHTA M.D. (NPI 1134408776)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134408776 NPI number — MRS. RACHANA KAUSHAL GANDHI MEHTA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GANDHI MEHTA
Provider First Name:
RACHANA
Provider Middle Name:
KAUSHAL
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GANDHI
Provider Other First Name:
RACHANA
Provider Other Middle Name:
BHARATKUMAR
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134408776
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
DUMC 3403
Provider Second Line Business Mailing Address:
DUKE UNIVERSITY MEDICAL CENTER, NEUROMUSCULAR DEPARTMEN
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
240-988-4666
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
MEDICAL CENTER BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WINSTON SALEM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27157-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-716-2255
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/14/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  2015-01622 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207R00000X , with the licence number: TRN#15985 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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