Organization
TG DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS GIANCARLO (PRESIDENT, TG DO PC)
(586) 445-9900
Entity
Organization
Contact information
Practice address
19699 E 8 MILE RD, SAINT CLAIR SHORES, MI 48080-1655
(586) 445-9900
Mailing address
19699 E 8 MILE RD, SAINT CLAIR SHORES, MI 48080-1655
(586) 445-9900
Taxonomy
Speciality
Code
Description
License number
State
2084D0003X
Diagnostic Neuroimaging (Psychiatry & Neurology) Physician
Primary
5101008581
MI
Other
Enumeration date
06/27/2007
Last updated
08/22/2020
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