Individual
DR. THOMAS K MATHEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1245 BERKSHIRE CT, ADRIAN, MI 49221-1367
(517) 265-9396
(517) 265-9396
Mailing address
1245 BERKSHIRE CT, ADRIAN, MI 49221-1367
(517) 265-9396
(517) 265-9396
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
032919
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1368616
—
MI
01
—
3407869482
BLUE CROSS AND BLUE SHIEL
MI
Enumeration date
07/15/2007
Last updated
07/15/2007
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