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Individual

JAMES THOMAS CORPUS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
25200 CENTER RIDGE RD, #3500, WESTLAKE, OH 44145
(440) 331-4088
(440) 331-4095
Mailing address
PO BOX 378, SANDUSKY, OH 44871-0378
(419) 626-6161
(419) 502-3511

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35070749C
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000365164
ANTHEM
01
0113811
UNITED HEALTHCARE
05
2342503
OH
01
341783789118
CARESOURCE
01
5886664
AETNA
01
F70749
SUMMACARE APEX
Enumeration date
02/23/2006
Last updated
05/15/2019
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