Individual
DR. SHYAM J. THAKKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER DR, MORGANTOWN, WV 26506-1200
(304) 598-4800
Mailing address
1307 FEDERAL ST, SUITE B100, PITTSBURGH, PA 15212-4769
(412) 359-8900
(412) 359-8977
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
30113
WV
207RG0100X
Gastroenterology Physician
MD424393
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102165370
—
PA
05
—
3114347
—
OH
05
—
3810012598
—
WV
Enumeration date
10/03/2006
Last updated
04/08/2022
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