Provider Demographics
NPI:1174514061
Name:SHAH-PARIKH, DIPTI (MD)
Entity type:Individual
Prefix:
First Name:DIPTI
Middle Name:
Last Name:SHAH-PARIKH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 WALNUT STREET
Mailing Address - Street 2:STE 122
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-1140
Mailing Address - Country:US
Mailing Address - Phone:215-368-1950
Mailing Address - Fax:215-368-9923
Practice Address - Street 1:1000 WALNUT ST
Practice Address - Street 2:STE 122
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-1140
Practice Address - Country:US
Practice Address - Phone:215-368-1950
Practice Address - Fax:215-368-9923
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD058174L207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA901284Medicare PIN
F85964Medicare UPIN