Provider Demographics
NPI:1841385952
Name:PARIKH, HEMENDRA S (MD)
Entity Type:Individual
Prefix:
First Name:HEMENDRA
Middle Name:S
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 1:9470 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-5722
Mailing Address - Country:US
Mailing Address - Phone:219-661-3260
Mailing Address - Fax:219-662-3765
Practice Address - Street 1:9470 BROADWAY
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-5722
Practice Address - Country:US
Practice Address - Phone:219-661-3260
Practice Address - Fax:219-662-3765
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01028260A208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100196530Medicaid
IND80229Medicare UPIN
IN100196530Medicaid