Provider Demographics
NPI:1023458742
Name:PAREKH, ASHWIN (MD)
Entity type:Individual
Prefix:
First Name:ASHWIN
Middle Name:
Last Name:PAREKH
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 1:5555 W. THUNDERBIRD
Mailing Address - Street 2:BANNER THUNDERBIRD MEDICAL CENTER
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306
Mailing Address - Country:US
Mailing Address - Phone:602-865-2627
Mailing Address - Fax:602-865-2632
Practice Address - Street 1:5555 W. THUNDERBIRD
Practice Address - Street 2:BANNER THUNDERBIRD MEDICAL CENTER
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306
Practice Address - Country:US
Practice Address - Phone:602-865-2627
Practice Address - Fax:602-865-2632
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-26
Last Update Date:2017-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ52647207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZR74060OtherTRAINING PERMIT