Provider Demographics
NPI:1871578088
Name:THAKUR, CHHATRAPAL S (MD)
Entity type:Individual
Prefix:DR
First Name:CHHATRAPAL
Middle Name:S
Last Name:THAKUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5300 W HILLSBORO BLVD
Mailing Address - Street 2:SUITE A-101
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-4395
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5300 W HILLSBORO BLVD
Practice Address - Street 2:SUITE A-101
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-4395
Practice Address - Country:US
Practice Address - Phone:954-571-7727
Practice Address - Fax:954-571-7708
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-09
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME82319207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL263993900Medicaid
FL263993900Medicaid
FL13368Medicare ID - Type Unspecified