Provider Demographics
NPI:1821064544
Name:PARIKH, PRANAV H (MD)
Entity Type:Individual
Prefix:
First Name:PRANAV
Middle Name:H
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 1:860 OMNI BLVD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4430
Mailing Address - Country:US
Mailing Address - Phone:757-232-8769
Mailing Address - Fax:757-232-8876
Practice Address - Street 1:400 SENTARA CIR
Practice Address - Street 2:SUITE 400
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5716
Practice Address - Country:US
Practice Address - Phone:757-645-3150
Practice Address - Fax:757-645-3145
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00316366OtherRR/MEDICARE
VA8552596001OtherCIGNA HEALTHCARE
VA72902OtherSENTARA/OPTIMA
VA104924OtherANTHEM BLUE CROSS BLUE SH
VA0417846OtherUNITED HEALTHCARE
VA010058023Medicaid
P00316366OtherRR/MEDICARE
VAH96210Medicare UPIN