Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208G00000X | Cardiothoracic Vascular Surgeon | 036112836 | IL |
Y | 208G00000X | Cardiothoracic Vascular Surgeon | D91723 | MD |
N | 208G00000X | Cardiothoracic Vascular Surgeon | MD071478L | PA |
NPI | 1134164239 |
---|---|
Provider Name | Thomas G Gleason |
First Address | Baltimore, MD 21264-4226 |
Second Address | Baltimore, MD 21201-7024 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2006 |
Last Update Date | 08/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H9188 | (02) |