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General NPI Number Information
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NPI Number | 1164561817
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Entity Type | Individual
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Provider Name | AMITA SANJAY PARIKH M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 1695 DULUTH HWY SUITE A
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5072
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Country | US
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Telephone | 770-822-4410
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Fax | 770-822-4055
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Provider Business Mailing Address
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Address Line | 1721 TELFAIR CHASE WAY
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5151
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Country | US
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Telephone | 678-985-0400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 044565
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License Number State | GA
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