Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 4301047053 | MI |
NPI | 1093713885 |
---|---|
Provider Name | Dr. Ranjan K Thakur |
First Address | Lansing, MI 48910-4699 |
Second Address | Lansing, MI 48912-1806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2005 |
Last Update Date | 17/06/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3014977 | (05) | MI |
B57099 | (02) | MI |