Provider Demographics
NPI:1063481190
Name:DUCKER, THOMAS P (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:P
Last Name:DUCKER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:345 SHERMAN ST
Mailing Address - Street 2:STE 100
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2401
Mailing Address - Country:US
Mailing Address - Phone:651-251-5500
Mailing Address - Fax:651-251-5555
Practice Address - Street 1:345 SHERMAN ST
Practice Address - Street 2:STE 100
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2401
Practice Address - Country:US
Practice Address - Phone:651-251-5500
Practice Address - Fax:651-251-5555
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2012-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN32853207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN0010066OtherPREFERREDONE
MN101255OtherUCARE MN
MN23304OtherAMERICA'S PPO
MN8T417DUOtherBLUE CROSS BLUE SHIELD MN
MN3600781OtherMEDICA
WI31845600Medicaid
MNHP13195OtherHEALTHPARTNERS
MN753708500Medicaid
MN23304OtherAMERICA'S PPO
MN0010066OtherPREFERREDONE
MNE57673Medicare UPIN