Provider Demographics
NPI:1295833952
Name:PAREKH, RAJUL A (NP)
Entity Type:Individual
Prefix:
First Name:RAJUL
Middle Name:A
Last Name:PAREKH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 602478
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-2478
Mailing Address - Country:US
Mailing Address - Phone:704-403-6100
Mailing Address - Fax:704-403-6131
Practice Address - Street 1:100 MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE 210
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28025-2966
Practice Address - Country:US
Practice Address - Phone:704-403-6100
Practice Address - Fax:704-403-6131
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC900412363L00000X
NC192514363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQNP087Medicaid
NC1295833952Medicaid
NC900412OtherLICENSE
NC7000936Medicaid
NC2809885AMedicare PIN
NC7000936Medicaid
NCNC7809AMedicare PIN
NC2809885BMedicare PIN