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Individual
MARK ALLEN THOMAS
Active
Individual
MARK ALLEN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
4704220074
MI
363LA2100X
Acute Care Nurse Practitioner
Primary
4704220074
MI
Other
Enumeration date
12/21/2006
Last updated
09/10/2012
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