Individual
MAITREYA B THAKKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 N WINSTEAD AVE, ROCKY MOUNT, NC 27804-8467
(252) 937-0229
(252) 937-3109
Mailing address
PO BOX 7200, ROCKY MOUNT, NC 27804-0200
(252) 937-0200
(252) 451-0056
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
9800714
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11362
BCBSNC
NC
01
—
2993265
CIGNA HEALTHCARE
NC
01
—
60050775
RAILROAD MEDICARE
NC
01
—
79995
MEDCOST
NC
05
—
8911362
—
NC
Enumeration date
09/08/2005
Last updated
07/21/2014
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