MEDICARE: DIPSY PARIKH

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	208200000X	Plastic Surgery Physician	6401	GA

General Provider Information

NPI Number	:	1629623558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIPSY PARIKH

Provider Business Mailing Address
First Line	:	1416 WALKER GRV NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30329-3573
Country	:	US
Telephone Number	:	404-993-5484
Fax Number	:

Provider Business Practice Location Address
First Line	:	3150 ROSWELL RD NE STE B1
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2572
Country	:	US
Telephone Number	:	404-993-5484
Fax Number	:

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

Provider Enumeration Date	:	08/07/2019
Last Update Date	:	08/07/2019

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Directions to “ DIPSY PARIKH ” Practice Location

Language	Start Address	Practice Location

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