Individual
THOMAS C TREVORROW
Active
Individual
THOMAS C TREVORROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD049389L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0014147820002
MEDICAL ASSISTANCE PROVID
PA
01
—
1040831
GATEWAY PROVIDER
PA
01
—
72340
MED PLUS
PA
01
—
735637
BLUE SHIELD PROVIDER
PA
01
—
735637-L3D
BLUE SHIELD PROVIDER
PA
Enumeration date
08/16/2005
Last updated
08/27/2007
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