Individual
THOMAS LEE DONNELLON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
120 N DELAWARE ST, SANDUSKY, MI 48471-1009
(810) 648-3770
Mailing address
3050 COMMERCE DR, FORT GRATIOT, MI 48059-3819
(810) 385-4441
(810) 385-1540
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301052611
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1073546883
—
MI
Enumeration date
07/08/2006
Last updated
06/05/2012
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