Provider Demographics
NPI:1710287735
Name:DEEPIKA K PAREKH MD PC
Entity Type:Organization
Organization Name:DEEPIKA K PAREKH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPIKA
Authorized Official - Middle Name:K
Authorized Official - Last Name:PAREKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:313-255-4820
Mailing Address - Street 1:17306 W 7 MILE RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-3043
Mailing Address - Country:US
Mailing Address - Phone:313-255-4820
Mailing Address - Fax:313-255-1338
Practice Address - Street 1:17306 W 7 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235-3043
Practice Address - Country:US
Practice Address - Phone:313-255-4820
Practice Address - Fax:313-255-1338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-25
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301035876261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0808227431OtherBLUE CROSS BLUE SHIELD PROVIDER CODE
MI10-1097809Medicaid
MIA77023Medicare UPIN
MI0822743Medicare PIN