Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 70482 | WI |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 01042371A | IN |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 70482 | WI |
NPI | 1124043047 |
---|---|
Provider Name | Thomas C. Wozniak |
First Address | Carmel, IN 46032-8562 |
Second Address | Carmel, IN 46032-8562 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2006 |
Last Update Date | 14/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100466950 | (05) | IN |