Basic Information
| Provider Information | |||||||||
| NPI: | 1043467194 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THAKUR | ||||||||
| FirstName: | PANKAJ | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 FORBES AVE STE 140 | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152133410 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 3471 FIFTH AVENUE | ||||||||
| Address2: | KAUFMANN BUILDING SUITE 402 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4126924572 | ||||||||
| FaxNumber: | 4126924515 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/20/2008 | ||||||||
| LastUpdateDate: | 04/05/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 309757 | LA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207Q00000X | 5821 | NE | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD443133 | PA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207L00000X | MT199578 | PA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 207SG0201X | MD443133 | PA | N | Allopathic & Osteopathic Physicians | Medical Genetics | Clinical Genetics (M.D.) |
ID Information
| ID | Type | State | Issuer | Description | MD443133 | 01 | PA | FELLOW-UPMC | OTHER | 014582 | 01 | PA | MEDICARE | OTHER | 1007288440104 | 05 | PA | MEDICAID |