Provider Demographics
NPI:1316391311
Name:THAKKAR, BADAL GIRISHBHAI (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:BADAL
Middle Name:GIRISHBHAI
Last Name:THAKKAR
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:150 BERGEN ST
Mailing Address - Street 2:UH-I-248
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07103-2496
Mailing Address - Country:US
Mailing Address - Phone:973-972-6056
Mailing Address - Fax:973-972-3129
Practice Address - Street 1:2401 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5216
Practice Address - Country:US
Practice Address - Phone:410-601-0594
Practice Address - Fax:410-601-0939
Is Sole Proprietor?:No
Enumeration Date:2016-04-16
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD86885207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program