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General NPI Number Information
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NPI Number | 1790711240
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Entity Type | Individual
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Provider Name | THOMAS E MAIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 823 SW MULVANE ST SUITE 1
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City | TOPEKA
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State | KS
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Zip | 66606-1679
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Country | US
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Telephone | 785-234-3451
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Fax | 785-234-2550
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Provider Business Mailing Address
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Address Line | 823 SW MULVANE ST SUITE 1
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City | TOPEKA
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State | KS
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Zip | 66606-1679
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Country | US
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Telephone | 785-234-3451
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Fax | 785-234-2550
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 04-15362
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | R7026
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License Number State | MO
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