Provider Demographics
NPI:1215032958
Name:PAREKH, PURVI SHAH (DO)
Entity type:Individual
Prefix:DR
First Name:PURVI
Middle Name:SHAH
Last Name:PAREKH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:PURVI
Other - Middle Name:PRADIP
Other - Last Name:SHAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:100 HOSPITAL AVE
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-1440
Mailing Address - Country:US
Mailing Address - Phone:814-371-7757
Mailing Address - Fax:814-375-0414
Practice Address - Street 1:145 HOSPITAL AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-1462
Practice Address - Country:US
Practice Address - Phone:814-371-7757
Practice Address - Fax:814-375-0414
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0061312207R00000X
MA235039207R00000X
PAOS012202207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110081257AMedicaid
MD405552700Medicaid
I24708Medicare UPIN
MD755LK555Medicare PIN
MA110081257AMedicaid