Healthcare Provider Details

I. General information

NPI: 1467412957
Provider Name (Legal Business Name): BAKUL K PARIKH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2006
Last Update Date: 05/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2006 HOGBACK RD LOWR LEVEL SUITE2
ANN ARBOR MI
48105-9750
US

IV. Provider business mailing address

2006 HOGBACK RD LOWR LEVEL SUITE 2
ANN ARBOR MI
48105-9750
US

V. Phone/Fax

Practice location:
  • Phone: 734-971-7716
  • Fax: 734-786-2316
Mailing address:
  • Phone: 734-971-7716
  • Fax: 734-786-4915

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number4301050539
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number4301050539
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: