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General NPI Number Information
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NPI Number | 1316916505
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Entity Type | Individual
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Provider Name | MULJIBHAI J THAKKAR MD
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Gender | Male
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Dates
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Enumeration Date | 03/17/2006
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Last Update Date | 07/03/2018
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Provider Practice Location Address
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Address Line | 6719 GOVERNOR G.C. PEERY HWY SUITE 2600
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City | RICHLANDS
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State | VA
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Zip | 24641-0279
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Country | US
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Telephone | 276-964-6649
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Fax | 276-964-5007
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Provider Business Mailing Address
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Address Line | 6719 GOVERNOR G.C. PEERY HWY SUITE 2600
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City | RICHLANDS
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State | VA
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Zip | 24641-0279
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Country | US
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Telephone | 276-964-6649
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Fax | 276-964-5007
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0101031664
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License Number State | VA
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