Healthcare Provider Details

I. General information

NPI: 1831945500
Provider Name (Legal Business Name): PARTH PRANAV PARIKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2024
Last Update Date: 06/26/2025
Certification Date: 06/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 SOUTH KINGSHIGHWAY BOULEVARD CAMPUS BOX 8131-19-01
ST. LOUIS MO
63110-1016
US

IV. Provider business mailing address

16420 EDGE WATER AVE
CHESTERFIELD MO
63017-4705
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-2978
  • Fax: 314-747-4671
Mailing address:
  • Phone: 573-795-2550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2025020060
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: