Provider Demographics
NPI:1548844335
Name:THAKUR, RAHUL KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:KUMAR
Last Name:THAKUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:ELM & CARLTON STS CSC BUILDING 8TH FLOOR 8C4A
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14263-1370
Mailing Address - Country:US
Mailing Address - Phone:347-593-2896
Mailing Address - Fax:
Practice Address - Street 1:ELM & CARLTON STS CSC BUILDING 8TH FLOOR 8C4A
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-3159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-08
Last Update Date:2025-03-30
Deactivation Date:2022-07-15
Deactivation Code:
Reactivation Date:2022-08-09
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY334352207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program