MEDICARE: DIPTI SHAH-PARIKH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MD058174L	PA

General Provider Information

NPI Number	:	1174514061
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIPTI SHAH-PARIKH MD

Provider Business Mailing Address
First Line	:	1000 WALNUT STREET
Second Line	:	STE 122
City	:	LANSDALE
State	:	PA
Zip	:	19446-1140
Country	:	US
Telephone Number	:	215-368-1950
Fax Number	:	215-368-9923

Provider Business Practice Location Address
First Line	:	1000 WALNUT ST
Second Line	:	STE 122
City	:	LANSDALE
State	:	PA
Zip	:	19446-1140
Country	:	US
Telephone Number	:	215-368-1950
Fax Number	:	215-368-9923

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	11/04/2009

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