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Individual
THOMAS M MUSHONG
Active
Individual
THOMAS M MUSHONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
5601003863
MI
363A00000X
Physician Assistant
Primary
5601003863
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110D111790
BCBSM
MI
01
—
P00397289
RAILROAD MEDICARE
MI
Enumeration date
02/17/2006
Last updated
09/04/2019
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