GAUTAM C THAKUR (NPI# 1578502167) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578502167 |
| Entity Type | Individual |
| Full Name | GAUTAM C THAKUR |
| Credential | MD |
| Practice Address |
751 Liberty St Meadville PA 16335-2559 |
| Mailing Address |
Po Box 1420 Clearfield PA 16830-5420 |
| Practice Telephone | 8143335144 |
| Practice Fax Number | 8143732255 |
| Mailing Telephone | 8772357686 |
| Mailing Fax Number | 8142351566 |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2020-02-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD061648L | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | 0016368510004 | 05 |
| Street Address |
751 LIBERTY ST |
| City | MEADVILLE |
| State | PA |
| Zip Code | 16335-2559 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245233568 | William D. Sullivan | Internal Medicine | 751 Liberty St, Meadville, PA 16335-2559 | 2005-05-31 |
| 1134745094 | Nico Ferreras | Family Medicine | 751 Liberty St, Meadville, PA 16335-2591 | 2020-06-17 |
| 1629699236 | Sarah Elizabeth Potts | Family Medicine | 751 Liberty St, Meadville, PA 16335-2559 | 2020-05-05 |
| 1225659667 | Jennifer Lynne Babins | Student in an Organized Health Care Education/Training Program | 751 Liberty St, Meadville, PA 16335-2591 | 2020-04-27 |
| 1699395509 | Zachary Paul Henderson | Family Medicine | 751 Liberty St, Meadville, PA 16335-2559 | 2020-04-21 |
| 1821635699 | Nicole Marie Temple | Physical Therapy Assistant | 751 Liberty St, Meadville, PA 16335-2591 | 2019-11-29 |
| 1235775651 | Alfred Leonard Hartick Iv | Physical Therapist | 751 Liberty St, Meadville, PA 16335-2559 | 2019-11-20 |
| 1215573936 | Melvin Burger Jr. | Physical Therapist | 751 Liberty St, Meadville, PA 16335-2559 | 2019-11-19 |
| 1588209589 | Ryan Brennan | Physical Therapist | 751 Liberty St, Meadville, PA 16335-2559 | 2019-11-13 |
| 1629633573 | Meadville Medical Center | Internal Medicine | 751 Liberty St, Meadville, PA 16335-2591 | 2019-05-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811533508 | Stacey Lynette Lantz | Physical Therapy Assistant | 11277 Vernon Place Road, Meadville, PA 16335 | 2019-11-18 |
| 1952874794 | Amy Lynn Weaver | Social Worker | Parkside Psychological Associates, 435 Chestnut Street, Meadville, PA 16335 | 2019-01-04 |
| 1013437789 | Raymond Walter Keller Jr. | Family Medicine | 735 Liberty St, Meadville, PA 16335 | 2017-06-23 |
| 1750735742 | Nicole Fies | Counselor | 201 Chestnut Street, Floor 2, Meadville, PA 16335 | 2016-04-16 |
| 1760894422 | Amie S Coffman | Psychiatry & Neurology | 765 Liberty St Ste 303, Meadville, PA 16335 | 2014-05-28 |
| 1649609710 | Gina Marie Michalak | Pharmacist | 379 North Street, Meadville, PA 16335 | 2013-11-08 |
| 1518396704 | Cassandra Lynn Ketler | Physician Assistant | 847 North Main Street, Meadville, PA 16335 | 2013-11-07 |
| 1194159913 | Judy Mcelwain | Speech-Language Pathologist | 31 N Park Ave, Meadville, PA 16335 | 2013-08-28 |
| 1649604463 | Jonelle Elizabeth Taylor | Occupational Therapist | 31 North Park Ave, Meadville, PA 16335 | 2013-08-28 |
| 1699046961 | James Richard Mclamb | Orthopaedic Surgery | 6060 Ehrgott Rd, Meadville, PA 16335 | 2012-01-19 |
| Find all providers in zip 16335 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326088691 | Meadville Diagnostic Medical Imaging Inc | Radiology | 751 Liberty Street, Meadville, PA 16335 | 2006-06-07 |
| 1558311183 | Frederic Thomas Mcdermott | Radiology | 751 Liberty St, Meadville, PA 16335-2559 | 2006-05-12 |
| 1649258062 | Michael O'malley | Radiology | 751 Liberty St, Meadville, PA 16335 | 2006-01-05 |
| 1750371852 | Philip Eisinger | Radiology | 751 Liberty St, Meadville, PA 16335-2559 | 2005-10-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396359014 | Kimberly Ann Nulph-laseck | Radiology | 65 Market St, Albion, PA 16401-1131 | 2020-08-31 |
| 1407478878 | Bridget Podbielski | Radiology | 1301 Summit Dr, Royersford, PA 19468-2873 | 2020-05-08 |
| 1063067635 | Jefferson University Radiology Associates, LLC | Radiology | 3 Crescent Dr Ste 1002, Philadelphia, PA 19112-1016 | 2019-08-09 |
| 1518522770 | Michael Anthony Branco | Radiology | 340 Wellslee Dr, Chambersburg, PA 17201-8289 | 2019-05-03 |
| 1700369535 | Tower Health Medical Group | Radiology | 301 S 7th Ave Ste 135, West Reading, PA 19611-1442 | 2018-09-07 |
| 1841784899 | Kyle Rives | Radiology | 200 Lothrop Street Upmc Presbyterian, South Tower 2nd Floor Suite 200, Pittsburgh, PA 15213 | 2018-06-21 |
| 1285128892 | Solomon Amemasor | Radiology | 200 Lothrop St Ste 200, Pittsburgh, PA 15213-2536 | 2018-06-18 |
| 1326545898 | Lehigh Valley Hospital | Radiology | 320 W Pumping Station Rd Ste 2, Quakertown, PA 18951-2345 | 2018-04-10 |
| 1376054874 | Irad Services, Inc. | Radiology | 1811 Golden Mile Hwy Ste B, Pittsburgh, PA 15239-2847 | 2017-10-24 |
| 1639689482 | Anna Maria Polizio | Radiology | 496 Cherry Ct, Pittsburgh, PA 15237-2608 | 2017-10-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.