1114084506 NPI number — DR. VAIBHAV A PAREKH M.D.

Table of content: DR. VAIBHAV A PAREKH M.D. (NPI 1114084506)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114084506 NPI number — DR. VAIBHAV A PAREKH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAREKH
Provider First Name:
VAIBHAV
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114084506
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 CALVARY CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LUTHERVILLE TIMONIUM
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21093-3956
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-321-6245
Provider Business Mailing Address Fax Number:
410-321-6245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3001 S HANOVER ST
Provider Second Line Business Practice Location Address:
STE 300, GRUEHN BLDG
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21225-1233
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-350-8222
Provider Business Practice Location Address Fax Number:
410-350-8220
Provider Enumeration Date:
01/03/2007

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: 207R00000X , with the licence number:  D0060842 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: D0060842 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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