Individual
DR. NITI THAKUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6200 PINE HOLLOW DR, SUITE 400, EAST LANSING, MI 48823-9700
(517) 339-1676
(517) 339-2716
Mailing address
6200 PINE HOLLOW DR, SUITE 400, EAST LANSING, MI 48823-9700
(517) 339-1676
(517) 339-2716
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
4301055581
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0331244
BLUE CARE NETWORK
MI
05
—
10-5214000
—
MI
01
—
1103312441
BLUE CROSS BLUE SHIELD
MI
01
—
200000002343
PHP
MI
Enumeration date
09/07/2007
Last updated
11/29/2011
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