Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | D86181 | MD |
N | 111NI0900X | Internist | D86181 | MD |
Y | 207RA0401X | Internist - Addiction Medicine | D86181 | MD |
NPI | 1790216166 |
---|---|
Provider Name | Ashish Prakash Thakrar |
First Address | Baltimore, MD 21220-2004 |
Second Address | Baltimore, MD 21287-0010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2017 |
Last Update Date | 07/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D86181 | (05) | MD |