Individual
THOMAS H MOULAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
615 S BOWER ST, GREENVILLE, MI 48838-2614
(616) 754-4691
Mailing address
615 S BOWER ST, GREENVILLE, MI 48838-2614
(616) 754-4691
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704072410
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4465435
—
MI
05
—
4594432
—
MI
Enumeration date
07/03/2006
Last updated
07/08/2007
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