Provider Demographics
NPI:1528262565
Name:PAREKH, SUSHMA (MD)
Entity type:Individual
Prefix:DR
First Name:SUSHMA
Middle Name:
Last Name:PAREKH
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 1:578 SW SANCTUARY DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2044
Mailing Address - Country:US
Mailing Address - Phone:772-785-9120
Mailing Address - Fax:
Practice Address - Street 1:578 SW SANCTUARY DR
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2044
Practice Address - Country:US
Practice Address - Phone:772-785-9120
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL43668207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine