Individual
THOMAS E MCKENZIE
Active
Individual
THOMAS E MCKENZIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704207439
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104593293
—
MI
01
—
P00237828
RAILROAD MEDICARE PIN
MI
01
—
TM207439
BLUESHIELD PIN
MI
Enumeration date
11/17/2005
Last updated
04/25/2008
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