Provider Demographics
NPI:1447242573
Name:WASCHER, THOMAS M (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:WASCHER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5320 MICHAELS DR
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54913-8446
Mailing Address - Country:US
Mailing Address - Phone:920-882-8200
Mailing Address - Fax:920-882-8210
Practice Address - Street 1:5320 MICHAELS DR
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54913-8446
Practice Address - Country:US
Practice Address - Phone:920-882-8200
Practice Address - Fax:920-882-8210
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2022-07-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI33776207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31863400Medicaid
F40976Medicare UPIN
WI31863400Medicaid