Provider Demographics
NPI:1902014988
Name:THAKURIA, ANIL CHANDRA
Entity Type:Individual
Prefix:DR
First Name:ANIL
Middle Name:CHANDRA
Last Name:THAKURIA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:ANIL
Other - Middle Name:CHANDRA
Other - Last Name:THAKURIAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD(MBBS)
Mailing Address - Street 1:8195 SANCTUARY DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-4638
Mailing Address - Country:US
Mailing Address - Phone:614-848-9425
Mailing Address - Fax:
Practice Address - Street 1:2900 CHARLEVOIX DR SE
Practice Address - Street 2:STE 200 , COMPHEALTH, PROSPECTIVE EMPLOYER
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49546-7085
Practice Address - Country:US
Practice Address - Phone:616-975-5000
Practice Address - Fax:616-975-5030
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.048186207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine