Provider Demographics
NPI: | 1134110729 |
---|---|
Name: | PARIKSHAK, NARENDRA D (MD) |
Entity Type: | Individual |
Prefix: | DR |
First Name: | NARENDRA |
Middle Name: | D |
Last Name: | PARIKSHAK |
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: | 1 DUNBAR PLZ |
Mailing Address - Street 2: | STE 200 |
Mailing Address - City: | DUNBAR |
Mailing Address - State: | WV |
Mailing Address - Zip Code: | 25064-3038 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 304-414-4800 |
Mailing Address - Fax: | 304-414-4801 |
Practice Address - Street 1: | 1 DUNBAR PLZ |
Practice Address - Street 2: | STE 200 |
Practice Address - City: | DUNBAR |
Practice Address - State: | WV |
Practice Address - Zip Code: | 25064-3038 |
Practice Address - Country: | US |
Practice Address - Phone: | 304-356-1556 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2005-11-02 |
Last Update Date: | 2020-10-14 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WV | 18183 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
WV | 0078045000 | Medicaid | |
WV | 0078045000 | Medicaid | |
WV | DT1767 | Other | GROUP MEDICARE PTAN |
WV | PO1404161 | Other | RR MEDICARE PTAN |
WV | B441 | Other | GROUP MEDICARE |
G07866 | Medicare UPIN | ||
WV | WV4928B441 | Medicare PIN |