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Individual

JOSHUA JAMES THOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6401 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4341
(763) 586-5923
(763) 392-5604
Mailing address
6401 UNIVERSITY AVE NE, FRIDLEY, MN 55432-4341
(763) 586-5923
(763) 392-5604

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
53216
MN
207Y00000X
Otolaryngology Physician
85990-20
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
MN
Enumeration date
08/24/2009
Last updated
10/16/2025
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