Basic Information
| Provider Information | |||||||||
| NPI: | 1073628616 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GUJARATHI | ||||||||
| FirstName: | PARUL | ||||||||
| MiddleName: | RAMESH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9293 STATE ROUTE 43 | ||||||||
| Address2: | SUITE B | ||||||||
| City: | STREETSBORO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442415374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306261113 | ||||||||
| FaxNumber: | 3306261133 | ||||||||
| Practice Location | |||||||||
| Address1: | 9293 STATE ROUTE 43 | ||||||||
| Address2: | SUITE B | ||||||||
| City: | STREETSBORO | ||||||||
| State: | OH | ||||||||
| PostalCode: | 442415374 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306261113 | ||||||||
| FaxNumber: | 3306261133 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2006 | ||||||||
| LastUpdateDate: | 07/13/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35-081224 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2399435 | 05 | OH | MEDICAID |