Individual
DR. MULJIBHAI J THAKKAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6719 GOVERNOR G.C. PEERY HWY, SUITE 2600, RICHLANDS, VA 24641-0279
(276) 964-6649
(276) 964-5007
Mailing address
6719 GOVERNOR G.C. PEERY HWY, SUITE 2600, RICHLANDS, VA 24641-0279
(276) 964-6649
(276) 964-5007
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0101031664
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006088414
—
VA
05
—
0087219000
—
WV
01
—
011104800
FEDERAL BLACK LUNG PROGRAM
VA
01
—
060108
ANTHEM
VA
01
—
1003658
UNITED MINE WORKERS ASSOCIATION
VA
05
—
64661788
—
KY
Enumeration date
03/17/2006
Last updated
07/03/2018
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