Provider Demographics
NPI:1780664078
Name:PAREKH, SUSANNE GELBKE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSANNE
Middle Name:GELBKE
Last Name:PAREKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:SUSANNE
Other - Middle Name:ROSA GERTRAUD
Other - Last Name:GELBKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3333 EVERGREEN DR NE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49525-9756
Mailing Address - Country:US
Mailing Address - Phone:616-364-4200
Mailing Address - Fax:616-364-7347
Practice Address - Street 1:3333 EVERGREEN DR NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49525-9756
Practice Address - Country:US
Practice Address - Phone:616-364-4200
Practice Address - Fax:616-364-7347
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2010-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301084823207L00000X
MA222840207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4694886Medicaid
M71590084Medicare ID - Type Unspecified