Provider Demographics
NPI:1255471645
Name:THAWANI, MEERA INDER
Entity Type:Individual
Prefix:MRS
First Name:MEERA
Middle Name:INDER
Last Name:THAWANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MEERA
Other - Middle Name:
Other - Last Name:KHANNA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8241 CHATHAM DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2050 N HAGGERTY RD
Practice Address - Street 2:SUITE 280
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-3795
Practice Address - Country:US
Practice Address - Phone:734-844-0800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201002153225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIN67360001OtherMEDICARE INDIVIDUAL NO.
MIN67360001OtherMEDICARE INDIVIDUAL NO.