Healthcare Provider Details

I. General information

NPI: 1588660476
Provider Name (Legal Business Name): DHAVAL PARIKH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2005
Last Update Date: 06/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 REGENCY CT STE 207
TOLEDO OH
43623-3092
US

IV. Provider business mailing address

4235 SECOR RD
TOLEDO OH
43623-4231
US

V. Phone/Fax

Practice location:
  • Phone: 419-471-0493
  • Fax: 419-474-0390
Mailing address:
  • Phone: 419-471-0493
  • Fax: 419-474-0390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35-083085
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number4301082741
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: