Provider Demographics
NPI:1821061391
Name:PAREKH, VIDURI (MD)
Entity Type:Individual
Prefix:DR
First Name:VIDURI
Middle Name:
Last Name:PAREKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:VIDURI
Other - Middle Name:PAREKH
Other - Last Name:DESAI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:541 MAIN ST
Mailing Address - Street 2:SUITE 301
Mailing Address - City:SOUTH WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1868
Mailing Address - Country:US
Mailing Address - Phone:781-952-1480
Mailing Address - Fax:781-952-1481
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 301
Practice Address - City:SOUTH WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1868
Practice Address - Country:US
Practice Address - Phone:781-952-1480
Practice Address - Fax:781-952-1481
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA211619207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H50006Medicare UPIN