Individual
DR. PRASHANTH DINESH THAKKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1020 N MASON RD, DIV IM CARDIOLOGY, STE 100, SAINT LOUIS, MO 63141-6666
(314) 362-1291
(314) 362-4278
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-1291
(314) 362-4278
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2021022015
MO
207RC0000X
Cardiovascular Disease Physician
2021022015
MO
207RI0011X
Interventional Cardiology Physician
Primary
2021022015
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200064696
—
MO
Enumeration date
04/19/2013
Last updated
04/17/2025
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