Provider Demographics
NPI:1861748485
Name:PARAB, SHARAYU R
Entity type:Individual
Prefix:DR
First Name:SHARAYU
Middle Name:R
Last Name:PARAB
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:SHERI
Other - Middle Name:R
Other - Last Name:PARAB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:701 W DIXIE ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-4774
Mailing Address - Country:US
Mailing Address - Phone:812-333-0440
Mailing Address - Fax:
Practice Address - Street 1:701 W DIXIE ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-4774
Practice Address - Country:US
Practice Address - Phone:812-333-0440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038384A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology