Individual
DR. DUSTIN M THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11108 PARKVIEW PLAZA DR, FORT WAYNE, IN 46845
(260) 266-5700
(260) 266-5910
Mailing address
11109 PARKVIEW PLAZA DR # 117, FORT WAYNE, IN 46845-1701
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01067563A
IN
207RC0000X
Cardiovascular Disease Physician
Q5294
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
471550YR99
MEDICARE
TX
Enumeration date
06/27/2008
Last updated
10/12/2022
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