Provider Demographics
NPI:1912385402
Name:PAREKH, SHIMOLI
Entity Type:Individual
Prefix:
First Name:SHIMOLI
Middle Name:
Last Name:PAREKH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12202 BRAXFIELD CT APT 11
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2047
Mailing Address - Country:US
Mailing Address - Phone:301-526-2613
Mailing Address - Fax:
Practice Address - Street 1:12202 BRAXFIELD CT
Practice Address - Street 2:11
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2046
Practice Address - Country:US
Practice Address - Phone:301-526-2613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2015-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA3813171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor