Provider Demographics
NPI:1134330954
Name:THAKER, HEMA SHAILAJA (MD)
Entity Type:Individual
Prefix:DR
First Name:HEMA
Middle Name:SHAILAJA
Last Name:THAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:HEMA
Other - Middle Name:SHAILAJA
Other - Last Name:NALLAMSHETTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:130 S BRYN MAWR AVE
Mailing Address - Street 2:DEPARTMENT OF RADIOLOGY
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010-3121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:130 S BRYN MAWR AVE
Practice Address - Street 2:DEPARTMENT OF RADIOLOGY
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010-3121
Practice Address - Country:US
Practice Address - Phone:484-337-4695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2013-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT1880222085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology