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Individual

AMIT KAUSHIK THAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
130 S BRYN MAWR AVE, SUITE H321, BRYN MAWR, PA 19010-3121
(484) 337-4097
(484) 337-4082
Mailing address
130 S BRYN MAWR AVE, SUITE H321, BRYN MAWR, PA 19010-3121
(484) 337-4097
(484) 337-4082

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
OS013859
PA
208M00000X
Hospitalist Physician
Primary
OS013859
PA

Other

Enumeration date
03/02/2007
Last updated
06/13/2017
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