Provider Demographics
NPI:1790804532
Name:SHARAD P PARIKH MD PC
Entity Type:Organization
Organization Name:SHARAD P PARIKH MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARAD
Authorized Official - Middle Name:
Authorized Official - Last Name:PARIKH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-831-4200
Mailing Address - Street 1:11905 W FLORISSANT AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLORISSANT
Mailing Address - State:MO
Mailing Address - Zip Code:63033-6778
Mailing Address - Country:US
Mailing Address - Phone:314-831-4200
Mailing Address - Fax:314-831-7632
Practice Address - Street 1:11905 W FLORISSANT AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6778
Practice Address - Country:US
Practice Address - Phone:314-831-4200
Practice Address - Fax:314-831-7632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2010-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO338672086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MODG2193OtherRAILROAD MEDICARE
MOA10969Medicare UPIN
MO990000523Medicare PIN