Provider Demographics
NPI:1306920905
Name:PARIKH, ARUN VASUDEV (MD)
Entity type:Individual
Prefix:
First Name:ARUN
Middle Name:VASUDEV
Last Name:PARIKH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1626 CLARENCE CT
Mailing Address - Street 2:GENESIS BEHAVIORAL SERVICES
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53095-8533
Mailing Address - Country:US
Mailing Address - Phone:262-338-8611
Mailing Address - Fax:262-338-3367
Practice Address - Street 1:1626 CLARENCE CT
Practice Address - Street 2:GENESIS BEHAVIORAL SERVICES
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53095-8533
Practice Address - Country:US
Practice Address - Phone:262-338-8611
Practice Address - Fax:262-338-3367
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI233730202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
1977818OtherECFMG CERTIFICATE NUMBER
WI30347500Medicaid
WI30347500Medicaid
BP2302002OtherDEA
WI30347500Medicaid