Individual
THOMAS WEEKLY
Active
Individual
THOMAS WEEKLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30929
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
102164
MEDICARE-TYPE UNSPECIFIED
AZ
01
—
110245891
RR MEDICARE
AZ
05
—
74090302
—
AZ
01
—
AZ0723310
BCBS
AZ
Enumeration date
03/24/2006
Last updated
10/26/2007
Update your record
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