Doctor Name: | THOMAS A GIGNAC |
NPI Number: | 1053318188 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 4301034185 |
Business Practice Address: | 133 S Main St Suite D Mount Clemens, MI - 480432308 |
Business Phone Number: | 5864651326 |
Business Fax Number: | 5864650329 |
Mailing Address: | 133 S Main St, Suite D MOUNT CLEMENS |
State: | MI |
Postal Code: | 480432308 |
Phone Number: | 5864651326 |
Fax Number: | 5864650329 |
NPI Enumeration Date: | 07/05/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 4301034185 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |