Individual
THOMAS J. TAKACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1697 LIBERTY AVE, CARDIOTHORACIC, VASCULAR, AND ENDOVASCULAR SURGERY, LINCOLN PARK, MI 48146-3517
(980) 322-3015
Mailing address
6540 BELLOWS LN # 110, FAVROT HALL, HOUSTON, TX 77030-2802
(980) 322-3015
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301402346
MI
208600000X
Surgery Physician
A51118
CA
Other
Enumeration date
11/12/2008
Last updated
02/08/2011
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