Basic Information
| Provider Information | |||||||||
| NPI: | 1922176668 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | PARRISH | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | HENRY FORD HEALTH SYSTEM | ||||||||
| Address2: | 2799 WEST GRAND BOULEVARD | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3139169106 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | HENRY FORD HEALTH SYSTEM | ||||||||
| Address2: | 2799 WEST GRAND BOULEVARD | ||||||||
| City: | DETROIT | ||||||||
| State: | MI | ||||||||
| PostalCode: | 48202 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3139169106 | ||||||||
| FaxNumber: | 3139161249 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/01/2006 | ||||||||
| LastUpdateDate: | 10/29/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | 4301076299 | MI | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
ID Information
| ID | Type | State | Issuer | Description | 0Q26008072 | 01 | FEDERAL BLACK LUNG | OTHER | 4989283 | 05 | MI | MEDICAID | 700H262300 | 01 | BLUE CROSS-BLUE CROSS | OTHER | 0Q26008 | 01 | BLUE CARE NETWORK | OTHER | 475105110 | 05 | MI | MEDICAID | 1006439 | 01 | MCCLAREN HEALTH | OTHER | DP076299 | 01 | COMMERCIAL-COMMERCIAL NUMBER | OTHER | 0Q26008072 | 01 | RR MEDICARE | OTHER | 0Q26008 | 01 | MI | BLUE CROSS/BLUE SHIED | OTHER | DP076299 | 01 | CHAMPUS-CHAMPUS | OTHER |