Healthcare Provider Details

I. General information

NPI: 1821064544
Provider Name (Legal Business Name): PRANAV H. PARIKH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 01/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 SENTARA CIR SUITE 400
WILLIAMSBURG VA
23188-5716
US

IV. Provider business mailing address

860 OMNI BLVD SUITE 303
NEWPORT NEWS VA
23606-4430
US

V. Phone/Fax

Practice location:
  • Phone: 757-645-3150
  • Fax: 757-645-3145
Mailing address:
  • Phone: 757-232-8769
  • Fax: 757-232-8876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101235946
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: