Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 37931 | WI |
N | 207XS0117X | Orthopaedic Spine Surgeon | 37931 | WI |
NPI | 1144287483 |
---|---|
Provider Name | Thomas Sunil Thomas |
First Address | Marshfield, WI 54449-5703 |
Second Address | Eau Claire, WI 54701-6149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2006 |
Last Update Date | 02/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32147300 | (05) | WI |
610080600 | US DEPT OF LABOR (01) | WI |
G10947 | (02) |