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General NPI Number Information
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NPI Number | 1548600638
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Entity Type | Organization
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Legal Business Name | TD OWEIS MD PLC
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Dates
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Enumeration Date | 07/03/2013
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 1528 LAWNDALE DR
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City | ROYAL OAK
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State | MI
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Zip | 48067-1158
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Country | US
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Telephone | 419-450-3768
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Fax |
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Provider Business Mailing Address
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Address Line | 1528 LAWNDALE DR
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City | ROYAL OAK
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State | MI
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Zip | 48067-1158
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Country | US
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Telephone | 419-450-3768
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/ACUTE CARE TRAUMA SURGEON
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Name | DR. THOMAS DANIEL OWEIS
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Credential | MD
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Telephone | 419-450-3768
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 4301059283
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License Number State | MI
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