Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 21810 | NE |
Y | 207RH0003X | Hematology & Oncology | 41104 | MN |
N | 207RX0202X | Medical Oncology | 41104 | MN |
NPI | 1023098480 |
---|---|
Provider Name | Stephan Thome |
First Address | Rochester, MN 55905-0001 |
Second Address | Mankato, MN 56001-4752 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2006 |
Last Update Date | 27/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G70821 | (02) |