Individual
MR. GERALD L THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
44555 WOODWARD AVE, SUITE 105, PONTIAC, MI 48341-5031
(248) 335-2977
(248) 858-3880
Mailing address
44555 WOODWARD AVE, SUITE 105, PONTIAC, MI 48341-5031
(248) 335-2977
(248) 858-3880
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
5601003758
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00135174
RAILROAD MEDICARE
MI
Enumeration date
05/02/2007
Last updated
07/09/2007
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