Individual
SIDDARTH THAKUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
487 LAKE CONCORD RD NE, CONCORD, NC 28025-2934
(704) 403-0300
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2018-01562
NC
208VP0000X
Pain Medicine Physician
2018-01562
NC
Other
Enumeration date
04/18/2012
Last updated
07/15/2024
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