1821064544 NPI number — PRANAV H. PARIKH M.D.

Table of content: PRANAV H. PARIKH M.D. (NPI 1821064544)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821064544 NPI number — PRANAV H. PARIKH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARIKH
Provider First Name:
PRANAV
Provider Middle Name:
H.
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:
1821064544
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/31/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
860 OMNI BLVD
Provider Second Line Business Mailing Address:
SUITE 303
Provider Business Mailing Address City Name:
NEWPORT NEWS
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23606-4430
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-232-8769
Provider Business Mailing Address Fax Number:
757-232-8876

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 SENTARA CIR
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
WILLIAMSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23188-5716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-645-3150
Provider Business Practice Location Address Fax Number:
757-645-3145
Provider Enumeration Date:
02/23/2006

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: 207R00000X , with the licence number:  0101235946 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: P00316366 . This is a "RR/MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8552596001 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 72902 . This is a "SENTARA/OPTIMA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 104924 . This is a "ANTHEM BLUE CROSS BLUE SH" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 0417846 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 010058023 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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