Individual ProviderHasumati Vijaykumar MehtaFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address518 Sandhurst Dr, Fayetteville, NC 28304-4426(910) 323-4091PECOS EnrollmentBased on the most recent information from CMS, provider Hasumati Vijaykumar Mehta does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1265401962Provider TypeIndividualFull NameMehta, Hasumati VijaykumarTitleDr.CredentialM.D.GenderFemaleSole ProprietorYesEnumeration Date3/15/2006Last Updated11/4/2011Contact InformationPractice LocationPractice Address518 Sandhurst Dr, Fayetteville, NC 28304-4426Phone(910) 323-4091Fax(910) 323-4092Mailing LocationMailing AddressPO Box 87169, Fayetteville, NC 28304-7169Phone(910) 323-4091Fax(910) 323-4092Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense20167North CarolinaProvider IdentifiersIDDescriptionIssuerID02145DescriptionOtherIssuerBCBS GROUP NUMBERNorth CarolinaID8958493DescriptionMedicaidIssuerUnlistedNorth CarolinaID208795DescriptionOtherIssuerPTANNorth Carolina