MEDICARE: DEEPIKA K PAREKH MD PC

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	261QP2300X	Primary Care Clinic/Center	4301035876	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0808227431	OTHER	MI	BLUE CROSS BLUE SHIELD PROVIDER CODE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1710287735
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEEPIKA K PAREKH MD PC

Provider Business Mailing Address
First Line	:	17306 W 7 MILE RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-3043
Country	:	US
Telephone Number	:	313-255-4820
Fax Number	:	313-255-1338

Provider Business Practice Location Address
First Line	:	17306 W 7 MILE RD
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48235-3043
Country	:	US
Telephone Number	:	313-255-4820
Fax Number	:	313-255-1338

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DEEPIKA K PAREKH
Credential	:	MD
Telephone Number	:	313-255-4820

Provider Enumeration Date	:	10/25/2010
Last Update Date	:	10/25/2010

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