Healthcare Provider Details

I. General information

NPI: 1639731284
Provider Name (Legal Business Name): SHAUNAQ PARIKH DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 12/26/2022
Certification Date: 12/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 MCKEAN AVE
CHARLEROI PA
15022-2141
US

IV. Provider business mailing address

1200 MCKEAN AVE
CHARLEROI PA
15022-2141
US

V. Phone/Fax

Practice location:
  • Phone: 724-483-6600
  • Fax:
Mailing address:
  • Phone: 724-483-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberOS021134
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: