Provider Demographics
NPI:1336285022
Name:GUINA, THOMAS MELVIN (PC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:MELVIN
Last Name:GUINA
Suffix:
Gender:M
Credentials:PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23420 FORD RD
Mailing Address - Street 2:
Mailing Address - City:DEARBORN HTS
Mailing Address - State:MI
Mailing Address - Zip Code:48127-2396
Mailing Address - Country:US
Mailing Address - Phone:313-563-9200
Mailing Address - Fax:313-563-9201
Practice Address - Street 1:23420 FORD RD
Practice Address - Street 2:
Practice Address - City:DEARBORN HTS
Practice Address - State:MI
Practice Address - Zip Code:48127-2396
Practice Address - Country:US
Practice Address - Phone:313-563-9200
Practice Address - Fax:313-563-9201
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI383245501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI141583865Medicaid
MI0Q25152Medicare ID - Type Unspecified