Individual
ASHISH PRAKASH THAKRAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4736 OSAGE AVE, PHILADELPHIA, PA 19143-1815
(610) 653-2406
Mailing address
6201 GREENLEIGH AVE, BALTIMORE, MD 21220-2004
(410) 933-6423
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D86181
MD
207RA0401X
Addiction Medicine (Internal Medicine) Physician
D86181
MD
207RA0401X
Addiction Medicine (Internal Medicine) Physician
Primary
MD474448
PA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D86181
—
MD
Enumeration date
03/27/2017
Last updated
02/06/2023
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