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Individual

MARK S THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
(651) 602-7500
(651) 602-7580
Mailing address
153 CESAR CHAVEZ ST, SAINT PAUL, MN 55107-2226
(651) 602-7500
(651) 602-7580

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35858
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01-16933
MEDICA
MN
05
0553794
NJ
01
105424
UCARE
MN
01
2F800TH
BCBS
MN
05
923877800
MN
01
HP17266
HEALTH PARTNERS
MN
01
NA9021019261
PREFERRED ONE
MN
Enumeration date
03/27/2006
Last updated
09/19/2018
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