Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 4301060374 | MI |
Y | 208600000X | Surgeon | 4301060374 | MI |
N | 2086S0102X | Surgical Critical Care | 4301060374 | MI |
NPI | 1194775205 |
---|---|
Provider Name | Thomas Joseph Rohs JR. |
First Address | Kalamazoo, MI 49048-1647 |
Second Address | Kalamazoo, MI 49048-1647 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2006 |
Last Update Date | 02/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0203904022 | BCBSM (01) | MI |
4166777 | (05) | MI |
G50271 | (02) | MI |