| Thomas K Thomas Md Pc | |
|
22480 Kelly Rd Suite 2 Eastpointe MI 48021-2623 | |
| (586) 776-3340 | |
| (586) 778-6460 |
| Full Name | Thomas K Thomas Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 22480 Kelly Rd, Eastpointe, Michigan |
| Authorized Official Name and Position | Thomas K Thomas (PHYSICIAN) |
| Authorized Official Contact | 5867763340 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas K Thomas Md Pc 842 Moorland Dr Grosse Pointe Woods MI 48236-1129 Ph: (586) 776-3340 | Thomas K Thomas Md Pc 22480 Kelly Rd Suite 2 Eastpointe MI 48021-2623 Ph: (586) 776-3340 |
| NPI Number | 1083606677 |
|---|---|
| Provider Enumeration Date | 08/18/2005 |
| Last Update Date | 02/26/2008 |
| Medicare PECOS PAC ID | 5597848028 |
|---|---|
| Medicare Enrollment ID | O20080207000169 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083606677 | NPI | - | NPPES |
| 71020001500026 | Other | MI | BC BS OF MICHIGAN |
| 1361698 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4301040256 (Michigan) | Primary |
| Provider Name | Thomas K Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376732073 PECOS PAC ID: 4880777317 Enrollment ID: I20080207000150 |
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