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Individual

THOMAS W GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1000 WALL ST, ANN ARBOR, MI 48105-1912
(734) 764-4190
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
4301097516
MI
207W00000X
Ophthalmology Physician
MD031064E
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0009703720001
PA
Enumeration date
04/17/2006
Last updated
10/15/2010
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