Thakur, Gautam C
Thakur, Gautam C is an individual health care provider with primary practice located at 751 Liberty St , Meadville PA 16335-2559. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Thakur, Gautam C can be contacted via phone (814) 333-5144.Contact Information
Primary practice address
751 Liberty St
Meadville PA 16335-2559
Phone: (814) 333-5144
Fax: (814) 373-2255
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | MD061648L | Pennsylvania |
Profile Details
| NPI number | 1578502167 |
|---|---|
| LBN Legal business name | Thakur, Gautam C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Feb 24th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578502167 | NPPES |
| Pennsylvania | MEDICAID | 0016368510004 |
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