Provider Demographics
NPI:1891997680
Name:LAKHANI, PARESH VINOD (MD)
Entity Type:Individual
Prefix:DR
First Name:PARESH
Middle Name:VINOD
Last Name:LAKHANI
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 1:4840 KENTUCKY ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-1310
Mailing Address - Country:US
Mailing Address - Phone:304-768-7384
Mailing Address - Fax:304-768-3377
Practice Address - Street 1:4840 KENTUCKY ST
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-1310
Practice Address - Country:US
Practice Address - Phone:304-768-7384
Practice Address - Fax:304-768-3377
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23789208D00000X
IL125.057340390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program