Individual
THOMAS GIANCARLO
Active
Individual
THOMAS GIANCARLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
5101008581
MI
2084N0600X
Clinical Neurophysiology Physician
5101008581
MI
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
5101008581
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780627018
TGDOPC MD ID
MI
05
—
3195326
—
MI
05
—
319532611
—
MI
01
—
700E010320
MNA BC ID
MI
01
—
700E020410
TGDOPC BC PIN
MI
01
—
P32190001
TGDOPC MR ID
MI
Enumeration date
06/14/2006
Last updated
01/18/2022
Update your record
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