Provider Demographics
NPI:1053356527
Name:THAKORE, YUAN-HUA NIMISH (MD)
Entity type:Individual
Prefix:
First Name:YUAN-HUA
Middle Name:NIMISH
Last Name:THAKORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-3734
Mailing Address - Country:US
Mailing Address - Phone:216-431-5800
Mailing Address - Fax:
Practice Address - Street 1:99 NORTHLINE CIR
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44119-1482
Practice Address - Country:US
Practice Address - Phone:216-692-8803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-0799792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9911775OtherMEDICARE GROUP
OH9911775OtherMEDICARE GROUP
OH4073701Medicare ID - Type UnspecifiedMEDICARE NUMBER