Provider Demographics
NPI:1386703858
Name:THAKER, RAJSHREE SRINIVAS (MD)
Entity type:Individual
Prefix:
First Name:RAJSHREE
Middle Name:SRINIVAS
Last Name:THAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:10215 FERNWOOD RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-1106
Mailing Address - Country:US
Mailing Address - Phone:301-493-4440
Mailing Address - Fax:301-493-9778
Practice Address - Street 1:10215 FERNWOOD RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1106
Practice Address - Country:US
Practice Address - Phone:301-493-4440
Practice Address - Fax:301-493-9778
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0070417207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI05684Medicare UPIN