Provider Demographics
NPI:1891260857
Name:THAKUR M.D,P.A
Entity Type:Organization
Organization Name:THAKUR M.D,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SARIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BADGAMIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:954-415-4421
Mailing Address - Street 1:5645 CORAL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33076-3124
Mailing Address - Country:US
Mailing Address - Phone:561-703-7022
Mailing Address - Fax:954-346-7632
Practice Address - Street 1:5300 W HILLSBORO BLVD STE 101A
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4395
Practice Address - Country:US
Practice Address - Phone:561-703-7022
Practice Address - Fax:954-346-7632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty