Individual
JEAN THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 LAFAYETTE AVE SE, SUITE 3000, GRAND RAPIDS, MI 49503-4650
(616) 685-6922
(616) 685-5105
Mailing address
245 STATE ST SE, GRAND RAPIDS, MI 49503-4328
(616) 685-1808
(616) 685-1850
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301056296
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2994990
—
MI
05
—
3492302
—
MI
05
—
4186045
—
MI
05
—
4597040
—
MI
05
—
4816020
—
MI
05
—
4888790
—
MI
05
—
4888807
—
MI
Enumeration date
05/26/2006
Last updated
06/30/2009
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