Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 4301039937 | MI |
NPI | 1023018330 |
---|---|
Provider Name | M V Thomas |
First Address | Flint, MI 48532-3614 |
Second Address | Flint, MI 48532-3614 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 22/04/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4269999 | (05) | MI |
A74889 | (02) | MI |