Doctor Name: | SCOTT G THOMAS |
NPI Number: | 1033196126 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 01037023A |
Business Practice Address: | 621 Memorial Dr South Bend, IN - 466011064 |
Business Phone Number: | 5742361888 |
Business Fax Number: | 5742361887 |
Mailing Address: | 621 Memorial Dr, SOUTH BEND |
State: | IN |
Postal Code: | 466011064 |
Phone Number: | 5742361888 |
Fax Number: | 5742361887 |
NPI Enumeration Date: | 12/29/2005 |
NPI Last Update Date: | 05/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0129X |
License Number: | 01037023A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Vascular Surgery |
Taxonomy Definition: | A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |