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Individual

CYRIAC THOMAS THACHET

Active
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Individual

CYRIAC THOMAS THACHET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD045339L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001273951
PA
01
0546984000
INDEPENDENCE BLUE CROSS
PA
01
1026843
KEYSTONE MERCY HEALTH
PA
01
1100949
KEYSTONE MERCY HEALTH
PA
01
110244602
RAILROAD MEDICARE
PA
01
1461
BRAVO HEALTH
PA
01
2776575
AETNA HMO
PA
01
3Y3535
HEALTH NET
PA
01
4622304
AETNA PPO
PA
01
473238
AETNA HMO
PA
01
538882
COVENTRY HEALTH AMERICA
PA
01
710859
HIGHMARK BLUE SHIELD
PA
Enumeration date
12/01/2005
Last updated
12/12/2013
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