Individual
MR. THOMAS LAMACCHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S., PA-C
Contact information
Practice address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Mailing address
4646 JOHN R ST, DETROIT, MI 48201-1916
(313) 576-1000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
5601004120
MI
363AS0400X
Surgical Physician Assistant
Primary
5601004120
MI
Other
Enumeration date
08/19/2006
Last updated
02/08/2021
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