Individual
DR. MUKESH K THAWANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2700 NW STEWART PKWY, ROSEBURG, OR 97471
(541) 677-1527
Mailing address
PO BOX 3777, PORTLAND, OR 97208-3777
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD156309
OR
207R00000X
Internal Medicine Physician
Primary
MD60084847
WA
208M00000X
Hospitalist Physician
MD156309
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0256050
WASHINGTON DOL
WA
05
—
8558678
—
WA
01
—
P00819285
RAIDROAD MEDICARE
WA
Enumeration date
08/21/2007
Last updated
09/26/2018
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