Individual
DR. ANAYET UDDIN THAKUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11109 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845-1701
(260) 266-1000
Mailing address
40100 HIGHWAY 27, DAVENPORT, FL 33837-5906
(863) 422-4971
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01080342A
IN
207R00000X
Internal Medicine Physician
Primary
ME 80853
FL
208M00000X
Hospitalist Physician
ME80853
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000595200
—
FL
01
—
01087
BCBS
FL
Enumeration date
08/09/2005
Last updated
01/02/2024
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