Individual
JEET THAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 ENGLISH CREEK AVE STE 909, EGG HARBOR TOWNSHIP, NJ 08234-5587
(609) 407-2380
Mailing address
2799 W GRAND BLVD, DETROIT, MI 48202-2608
(313) 916-1601
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25MA10876800
NJ
Other
Enumeration date
03/29/2017
Last updated
08/06/2020
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