Individual
VIPUL V THAKKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
228 S HERLONG AVE, ROCK HILL, SC 29732-1158
(803) 366-5186
(803) 366-5730
Mailing address
200 QUEENS RD, SUITE 400, CHARLOTTE, NC 28204-3253
(704) 333-7376
(704) 333-3397
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
200701182
NC
2085R0001X
Radiation Oncology Physician
Primary
30229
SC
2085R0001X
Radiation Oncology Physician
35081789
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1460E
BLUE CROSS
NC
01
—
199820
MEDCOST
NC
01
—
3591870
CIGNA
NC
05
—
5907146
—
NC
01
—
811304
PARTNERS
NC
05
—
N01182
—
SC
Enumeration date
08/11/2006
Last updated
12/18/2012
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