Provider Demographics
NPI:1043364862
Name:RUPARELIA, NAVINCHANDRA M (MD)
Entity Type:Individual
Prefix:
First Name:NAVINCHANDRA
Middle Name:M
Last Name:RUPARELIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4904 TIMBER RIDGE DR
Mailing Address - Street 2:SUITE 202A
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-1828
Mailing Address - Country:US
Mailing Address - Phone:770-949-6548
Mailing Address - Fax:770-949-9561
Practice Address - Street 1:4904 TIMBER RIDGE DR
Practice Address - Street 2:SUITE 202A
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-1828
Practice Address - Country:US
Practice Address - Phone:770-949-6548
Practice Address - Fax:770-949-9561
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA26928207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00301122AMedicaid
D42179Medicare UPIN