Individual
THOMAS P VARIED
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5215 HOLY CROSS PARKWAY, MISHAWAKA, IN 46545-1469
(574) 335-5000
(574) 472-6262
Mailing address
810 PARK PL, MISHAWAKA, IN 46545-3520
(574) 472-6715
(574) 472-6746
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01062740A
IN
207R00000X
Internal Medicine Physician
4301074457
MI
208M00000X
Hospitalist Physician
01062740A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000613082
BCBS
IN
01
—
110240885
RAILROAD MEDICARE
MI
01
—
110E26038
BCBSM
MI
05
—
200837930
—
IN
05
—
4416092
—
MI
Enumeration date
06/13/2005
Last updated
11/01/2024
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