Provider Demographics
NPI:1760482384
Name:PARIKH, SHARAD P (MD)
Entity Type:Individual
Prefix:DR
First Name:SHARAD
Middle Name:P
Last Name:PARIKH
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 1:3450 BRIDGELAND DR
Mailing Address - Street 2:STE F
Mailing Address - City:BRIDGETON
Mailing Address - State:MO
Mailing Address - Zip Code:63044-2605
Mailing Address - Country:US
Mailing Address - Phone:314-831-4200
Mailing Address - Fax:314-831-7632
Practice Address - Street 1:3450 BRIDGELAND DR
Practice Address - Street 2:STE F
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2605
Practice Address - Country:US
Practice Address - Phone:314-831-4200
Practice Address - Fax:314-831-7632
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-26
Last Update Date:2015-10-21
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-23
Provider Licenses
StateLicense IDTaxonomies
MO338672086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO770000866OtherRAILROAD MEDICARE
MO200886505Medicaid
MO200886505Medicaid
MO770000866OtherRAILROAD MEDICARE