Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 125058804 | IL |
N | 111NI0900X | Internist | 125058804 | IL |
Y | 207RN0300X | Nephrologist | 61619 | MN |
NPI | 1063722767 |
---|---|
Provider Name | Surabhi B. Thakar |
First Address | Minneapolis, MN 55455-4800 |
Second Address | Minneapolis, MN 55455-4800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/10/2010 |
Last Update Date | 16/08/2017 |