Individual
TARA Y THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2165 WHITE BEAR AVE N, MAPLEWOOD, MN 55109-2707
(651) 523-9800
(651) 523-9801
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
60603
MN
Other
Enumeration date
06/13/2007
Last updated
08/23/2022
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