Healthcare Provider Details

I. General information

NPI: 1841592847
Provider Name (Legal Business Name): GRISHMA PARIKH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2010
Last Update Date: 06/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 WEST FRANCIS STREET SUITE 200
NORTH PLATTE NE
69101-0614
US

IV. Provider business mailing address

611 WEST FRANCIS STREET SUITE 200
NORTH PLATTE NE
69101-0614
US

V. Phone/Fax

Practice location:
  • Phone: 308-534-9230
  • Fax: 308-534-5016
Mailing address:
  • Phone: 308-534-9230
  • Fax: 308-534-5016

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number257994
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number26633
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: