Healthcare Provider Details

I. General information

NPI: 1841852886
Provider Name (Legal Business Name): MEHUL SHAILESH THAKKAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2019
Last Update Date: 10/24/2025
Certification Date: 10/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8326 NAAB RD
INDIANAPOLIS IN
46260-1920
US

IV. Provider business mailing address

8326 NAAB RD
INDIANAPOLIS IN
46260-1920
US

V. Phone/Fax

Practice location:
  • Phone: 317-871-0000
  • Fax: 317-871-0010
Mailing address:
  • Phone: 317-871-0000
  • Fax: 317-871-0010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number01095379A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2022025512
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: