Individual
GNAN N THAKORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
30 E APPLE ST STE 5254A, DAYTON, OH 45409
(937) 208-4200
(937) 208-4205
Mailing address
3170 KETTERING BLVD BLDG B3, MORAINE, OH 45439-1924
(937) 991-3188
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
35067458
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000012175
ANTHEM BCBS
OH
05
—
0987160
—
OH
01
—
4820078
UNITED HEALTHCARE
OH
Enumeration date
08/22/2005
Last updated
12/17/2018
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