Individual
DR. THOMAS J DITKOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301030676
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0767220001
ADMINISTAR FEDERAL
MI
01
—
0F31114
BCBS
MI
01
—
0F33583
BCBS DME
MI
05
—
2751179
—
MI
Enumeration date
11/14/2005
Last updated
01/12/2010
Update your record
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