Individual
THOMAS THYSSERIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
18051 JEFFERSON PARK RD STE 106, CLEVELAND, OH 44130-3460
(440) 816-5790
Mailing address
PO BOX 638269, CINCINNATI, OH 45263-0001
(440) 816-6433
(440) 816-6438
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35-068545
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0298191
—
OH
01
—
260032152
RAILROAD MEDICARE
OH
Enumeration date
12/19/2005
Last updated
07/23/2015
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