Provider Demographics
NPI:1164455200
Name:THAKOR, RUCHIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:RUCHIRA
Middle Name:
Last Name:THAKOR
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 1:4 W ROLLING XRDS STE 100
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-6277
Mailing Address - Country:US
Mailing Address - Phone:410-869-0100
Mailing Address - Fax:410-601-7317
Practice Address - Street 1:4 W ROLLING CROSSROADS
Practice Address - Street 2:SUITE 100
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21228-6280
Practice Address - Country:US
Practice Address - Phone:410-869-0100
Practice Address - Fax:410-601-7317
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0038041207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0029OtherCAREFIRST DC
9983OtherKAISER
112467OtherCOVENTRY
281959OtherMAMSI
7134748001OtherCIGNA
MD200491700Medicaid
2330331OtherAETNA HMO
52539002OtherCAREFIRST MARYLAND
7209097OtherAETNA PPO
MD118890Medicaid
011736OtherJOHNS HOPKINS HEALTHCARE
MD1980256Medicaid
1926506OtherUNITED HEALTHCARE
700272OtherNCPPO
80141003Medicare ID - Type UnspecifiedMEDICARE RAILROAD