Provider Demographics
NPI:1992785455
Name:THAKER, NIRANJANA SHAH (MD)
Entity type:Individual
Prefix:DR
First Name:NIRANJANA
Middle Name:SHAH
Last Name:THAKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:THAKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:88 CENTER RD
Mailing Address - Street 2:SUITE 250B
Mailing Address - City:BEDFORD
Mailing Address - State:OH
Mailing Address - Zip Code:44146-2700
Mailing Address - Country:US
Mailing Address - Phone:440-439-9797
Mailing Address - Fax:440-439-9775
Practice Address - Street 1:88 CENTER RD
Practice Address - Street 2:SUITE 250B
Practice Address - City:BEDFORD
Practice Address - State:OH
Practice Address - Zip Code:44146-2700
Practice Address - Country:US
Practice Address - Phone:440-439-9797
Practice Address - Fax:440-439-9775
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2008-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35041778207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000121950OtherUNICARE
OHR41778OtherSUMMACARE
OH000000121950OtherANTHEM BLUE SHIELD
OH353365OtherWEWLLCARE OF OHIO INC
OH0365993Medicaid
OH000000121950OtherANTHEM BLUE SHIELD
OH0365993Medicaid
OH0467586Medicare PIN