Individual
HARSH ANISH THACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22250 PROVIDENCE DRIVE, 7PMB SUITE #703A, SOUTHFIELD, MI 48075-4818
(248) 849-5862
Mailing address
22250 PROVIDENCE DRIVE, 7PMB SUITE #703A, SOUTHFIELD, MI 48075-4818
(248) 849-5862
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4351050213
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/14/2022
Last updated
02/14/2023
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