Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 34002905 | OH |
NPI | 1922030592 |
---|---|
Provider Name | Dr. Thomas M Shirck |
First Address | Dublin, OH 43017-7532 |
Second Address | Dublin, OH 43017-7532 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0489350 | (05) | OH |
A80342 | (02) | OH |