Healthcare Provider Details

I. General information

NPI: 1184618779
Provider Name (Legal Business Name): THOMAS ALAN PIIRA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2005
Last Update Date: 11/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

793 W STATE ST MCW HOSPITAL PATHOLOGY DEPT
COLUMBUS OH
43222-1551
US

IV. Provider business mailing address

PO BOX 951427
CLEVELAND OH
44193-0016
US

V. Phone/Fax

Practice location:
  • Phone: 614-234-5819
  • Fax: 614-234-2931
Mailing address:
  • Phone: 614-457-8180
  • Fax: 614-442-2403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZH0000X
TaxonomyHematology (Pathology) Physician
License Number35065684
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number35065684
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: