Provider Demographics
NPI:1508047457
Name:THAKUR, BHUP SINGH (PT)
Entity Type:Individual
Prefix:
First Name:BHUP
Middle Name:SINGH
Last Name:THAKUR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2152 TIMBERRIDGE CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1463
Mailing Address - Country:US
Mailing Address - Phone:248-787-2761
Mailing Address - Fax:
Practice Address - Street 1:2152 TIMBERRIDGE CT
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48324-1463
Practice Address - Country:US
Practice Address - Phone:248-787-2761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-20
Last Update Date:2007-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501004748225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist