1225007412 NPI number — NARESH J SOLANKI M.D.

Table of content: NARESH J SOLANKI M.D. (NPI 1225007412)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225007412 NPI number — NARESH J SOLANKI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SOLANKI
Provider First Name:
NARESH
Provider Middle Name:
J
Provider Name Prefix Text:
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:
1225007412
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 BREVCO PLZ
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
LAKE ST LOUIS
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63367-1392
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
636-561-5437
Provider Business Mailing Address Fax Number:
636-561-5100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 BREVCO PLZ
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
LAKE ST LOUIS
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63367-1392
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-561-5437
Provider Business Practice Location Address Fax Number:
636-561-5100
Provider Enumeration Date:
03/17/2006

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: 2080A0000X , with the licence number:  R2A26 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 201171634 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100957 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 8630 . This is a "GROUP HEALTH PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 1209358 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 409446 . This is a "PRUDENTIAL" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 7890 . This is a "BLUE SHIELD" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: PC11413 . This is a "CIGNA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 500012 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 5758046 . This is a "AETNA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: F28413 . This is a "MERCY HEALTH PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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