Provider Demographics
NPI:1821099961
Name:PARIKH, ROSHAN PIYUSHBHAI (MD)
Entity Type:Individual
Prefix:DR
First Name:ROSHAN
Middle Name:PIYUSHBHAI
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:PO BOX 87022
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-7022
Mailing Address - Country:US
Mailing Address - Phone:910-323-1800
Mailing Address - Fax:910-323-4030
Practice Address - Street 1:2944 BREEZEWOOD AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28303-5415
Practice Address - Country:US
Practice Address - Phone:910-323-1800
Practice Address - Fax:910-323-4030
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2011-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9700123207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1077JOtherBCBS
NC891077JMedicaid
NCP00153992OtherRAILROAD MEDICARE
NC1077JOtherBCBS
NCP00153992OtherRAILROAD MEDICARE