Provider Demographics
NPI:1407972193
Name:SUSHMA C PAREKH
Entity Type:Organization
Organization Name:SUSHMA C PAREKH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSHMA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAREKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:901-682-3905
Mailing Address - Street 1:5849 GARDEN RIVER CV
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-2501
Mailing Address - Country:US
Mailing Address - Phone:901-682-3905
Mailing Address - Fax:901-682-3905
Practice Address - Street 1:310 FALLS BLVD S
Practice Address - Street 2:
Practice Address - City:WYNNE
Practice Address - State:AR
Practice Address - Zip Code:72396-3013
Practice Address - Country:US
Practice Address - Phone:870-208-2151
Practice Address - Fax:870-208-2157
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-26552085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARG99964Medicare UPIN
AR5L701Medicare ID - Type Unspecified