MEDICARE: DR. J MICHAEL THUNEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	35050734	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215993415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. J MICHAEL THUNEY MD

Provider Business Mailing Address
First Line	:	2110 LEITER RD
Second Line	:
City	:	MIAMISBURG
State	:	OH
Zip	:	45342-3660
Country	:	US
Telephone Number	:	937-384-4838
Fax Number	:	937-384-4845

Provider Business Practice Location Address
First Line	:	4441 FAR HILLS AVE
Second Line	:
City	:	KETTERING
State	:	OH
Zip	:	45429-2405
Country	:	US
Telephone Number	:	937-298-7351
Fax Number	:	937-298-9458

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2006
Last Update Date	:	09/03/2010

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