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General NPI Number Information
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NPI Number | 1407972193
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Entity Type | Organization
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Legal Business Name | SUSHMA C PAREKH
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 03/18/2008
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Provider Practice Location Address
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Address Line | 310 FALLS BLVD S
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City | WYNNE
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State | AR
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Zip | 72396-3013
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Country | US
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Telephone | 870-208-2151
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Fax | 870-208-2157
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Provider Business Mailing Address
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Address Line | 5849 GARDEN RIVER CV
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City | MEMPHIS
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State | TN
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Zip | 38120-2501
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Country | US
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Telephone | 901-682-3905
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Fax | 901-682-3905
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SUSHMA PAREKH
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Credential | MD
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Telephone | 901-682-3905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | E-2655
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License Number State | AR
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