Individual
CHANDRANI GANPAT THAKKER VI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 PENNSYLVANIA AVE, CHILDRENS MEDICINE CENTER, CHARLESTON, WV 25302-3351
(304) 388-2525
(304) 388-2537
Mailing address
800 PENNSYLVANIA AVE, CHILDRENS MEDICINE CENTER, CHARLESTON, WV 25302-3351
(304) 388-2525
(304) 388-2537
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12966
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0112794000
—
WV
01
—
12966
MEDICAL LICENSE
WV
Enumeration date
10/17/2006
Last updated
04/24/2013
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