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NPI Code Detail

MEDICARE: DR. THOMAS JOSEPH MILLERICK JR. MD

MEDICARE: DR. THOMAS JOSEPH MILLERICK JR. 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
1207R00000XInternal Medicine PhysicianMD07313RI

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
8709003943OTHERRIMEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
104-00378OTHERRIUNITED HEALTH CARE
2050483739OTHERRIGREAT WEST HEALTH CARE
312277884OTHERRIMULTI PLAN
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
52046289OTHERRIHEALTH CARE VALUE MGT
62239332OTHERRIAETNA
729311-0OTHERRIBCBS OF RI
9200893OTHERRIBLUE CHIP
10050483739OTHERRIHEALTH NET / TRI CARE
113888906OTHERRICIGNA
12302210OTHERRITUFTS HEALTH PLAN
1365228OTHERRIHAVARD HEALTH PLAN

General Provider Information

NPI Number : 1477540185
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS JOSEPH MILLERICK JR. MD
Provider Business Mailing Address
First Line : 725 RESERVOIR AVE STE 103
Second Line :
City : CRANSTON
State : RI
Zip : 02910-4451
Country : US
Telephone Number : 401-829-4446
Fax Number : 401-829-4434
Provider Business Practice Location Address
First Line : 725 RESERVOIR AVE STE 103
Second Line :
City : CRANSTON
State : RI
Zip : 02910-4451
Country : US
Telephone Number : 401-829-4446
Fax Number : 401-829-4434
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2005
Last Update Date : 11/05/2024

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