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Individual

NEIL B THACKAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-7243
(336) 716-7432
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-1331

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
11860
GA
2085R0202X
Diagnostic Radiology Physician
Primary
2025-01950
NC

Other

Enumeration date
06/12/2020
Last updated
09/05/2025
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