Provider Demographics
NPI:1558458554
Name:PAREKH, BINA K (DO)
Entity Type:Individual
Prefix:
First Name:BINA
Middle Name:K
Last Name:PAREKH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9660 WICKER AVENUE
Mailing Address - Street 2:
Mailing Address - City:ST JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-9487
Mailing Address - Country:US
Mailing Address - Phone:219-365-1166
Mailing Address - Fax:219-365-8852
Practice Address - Street 1:9660 WICKER AVENUE
Practice Address - Street 2:
Practice Address - City:ST JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-9487
Practice Address - Country:US
Practice Address - Phone:219-365-1166
Practice Address - Fax:219-365-8852
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101015986207Q00000X
IN02003629A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4930221Medicaid
MI4930240Medicaid
MI4930277Medicaid
MI1598712390OtherGROUP NPI
MI4930203Medicaid
MI4930188Medicaid
MI5101015986OtherSTATE LICENSE NUMBER
MII640114Medicare UPIN
MI4930277Medicaid