Provider Demographics
NPI:1881675064
Name:PARIKH, GAURAV T (MD)
Entity Type:Individual
Prefix:
First Name:GAURAV
Middle Name:T
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 1:2500 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-3402
Mailing Address - Country:US
Mailing Address - Phone:304-264-1344
Mailing Address - Fax:304-260-1490
Practice Address - Street 1:1840 AMHERST ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-2808
Practice Address - Country:US
Practice Address - Phone:540-536-2270
Practice Address - Fax:540-536-7847
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2016-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME92638208M00000X
VA0101239453208M00000X, 207R00000X
WV24382208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010261252Medicaid
WV3810005063Medicaid
VAP00328063OtherRAILROAD MEDICARE
VA192481OtherBCBS OF VA
VAP00328063OtherRAILROAD MEDICARE
WV3810005063Medicaid
VAVVK567AMedicare PIN