Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | C10007736 | DE |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | C10007736 | DE |
NPI | 1801988654 |
---|---|
Provider Name | Mihir Thacker |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 03/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0076317 | (05) | NJ |
101494561 | (05) | PA |
4086201 | (05) | MD |
I43554 | (02) |