Individual
JOSE MATHEW THEKKEKARA
Active
Individual
JOSE MATHEW THEKKEKARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
8941
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11830250
CAQH
—
05
—
1649314683
—
NV
01
—
P01092343
RR MEDICARE PIN
NV
Enumeration date
02/15/2007
Last updated
11/05/2018
Update your record
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