Organization
OLNEY MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAURANG THAKER MD (OWNER)
(301) 774-5260
Entity
Organization
Contact information
Practice address
3411 OLANDWOOD CT, SUITE 105, OLNEY, MD 20832-1488
(301) 774-5260
(301) 774-1336
Mailing address
PO BOX 157, ASHTON, MD 20861-0157
(301) 570-9700
(301) 260-2838
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D43430
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
488302100
—
MD
Enumeration date
07/05/2006
Last updated
06/30/2010
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