Provider Demographics
NPI:1396746889
Name:PARIKH, SAMIR J (MD)
Entity type:Individual
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First Name:SAMIR
Middle Name:J
Last Name:PARIKH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:2800 SPRING ARBOR RD STE 102
Mailing Address - Street 2:PO BOX 905
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3895
Mailing Address - Country:US
Mailing Address - Phone:517-783-2612
Mailing Address - Fax:517-783-5991
Practice Address - Street 1:205 N EAST AVE
Practice Address - Street 2:IMAGING DEPT
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1753
Practice Address - Country:US
Practice Address - Phone:517-783-2612
Practice Address - Fax:517-783-5991
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2015-11-05
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Provider Licenses
StateLicense IDTaxonomies
MI43010630212085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI3003388231OtherBCBS OF MICHIGAN
MI4589970Medicaid
MI4301063021OtherSTATE OF MICHIGAN MEDICAL LICENSE
P00110238OtherRAILROAD MEDICARE
P00110238OtherRAILROAD MEDICARE