Individual
MS. MICHELLE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
279 SUMMIT DR, WATERFORD, MI 48328-3364
(248) 724-7700
(248) 636-4025
Mailing address
PO BOX 430150, PONTIAC, MI 48343-0150
(248) 724-7700
(248) 636-4025
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704130444
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4726059
—
MI
Enumeration date
01/08/2007
Last updated
03/05/2015
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