Healthcare Provider Details

I. General information

NPI: 1154346146
Provider Name (Legal Business Name): MICHAEL A THOMAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7675 WELLNESS WAY
WEST CHESTER OH
45069-2509
US

IV. Provider business mailing address

7675 WELLNESS WAY
WEST CHESTER OH
45069-2509
US

V. Phone/Fax

Practice location:
  • Phone: 513-475-8588
  • Fax: 513-475-8267
Mailing address:
  • Phone: 513-475-8588
  • Fax: 513-475-8267

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number35-056711
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35-056711
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number35-056711
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number35-056711
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number33328
License Number StateKY
# 6
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number33328
License Number StateKY
# 7
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number33328
License Number StateKY
# 8
Primary TaxonomyN
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number33328
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: