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Individual

DR. THOMAS JEFFERSON VANDERMEER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
212422-1
NY
208600000X
Surgery Physician
Primary
MD066677L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0017090630001
PA
05
01876677
NY
01
020046847
RR MEDICARE PIN
PA
01
CC9269
RR MEDICARE GROUP
PA
01
GU039818
PA MEDICARE GROUP
PA
Enumeration date
02/24/2006
Last updated
03/26/2019
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