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NPI Code Detail

MEDICARE: DR. THOMAS R DOERR M.D.

MEDICARE: DR. THOMAS R DOERR M.D.
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
1208200000XPlastic Surgery PhysicianTD036578MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12402800852OTHERMIBLUE CROSS BLUE SHIELD
22402800852OTHERMIBLUE CARE NETWORK
3900003054OTHERMIPRIORITY HEALTH
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5382629298OTHERMITRICARE

General Provider Information

NPI Number : 1699886168
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS R DOERR M.D.
Provider Business Mailing Address
First Line : 213 S MADISON ST
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2321
Country : US
Telephone Number : 231-947-0220
Fax Number : 231-947-1629
Provider Business Practice Location Address
First Line : 213 S MADISON ST
Second Line :
City : TRAVERSE CITY
State : MI
Zip : 49684-2321
Country : US
Telephone Number : 231-947-0220
Fax Number : 231-947-1629
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 04/30/2010

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Directions to “ DR. THOMAS R DOERR M.D.” Practice Location

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