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Individual

YOGENDRA K. THAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
80 MECHANIC ST, ATHOL, MA 01331-3534
(978) 249-2347
(978) 249-6333
Mailing address
80 MECHANIC ST, ATHOL, MA 01331-3534
(978) 249-2347
(978) 249-6333

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
71439
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3050071439
MA
Enumeration date
09/29/2005
Last updated
11/04/2010
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