Provider Demographics
NPI:1457855991
Name:THOMAS, SHERWIN ZACHARIAH (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERWIN
Middle Name:ZACHARIAH
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51577 MERRY LN
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48316-3860
Mailing Address - Country:US
Mailing Address - Phone:586-726-9374
Mailing Address - Fax:407-518-3923
Practice Address - Street 1:720 W. OAK ST., STE 201
Practice Address - Street 2:
Practice Address - City:KISSIMMEE
Practice Address - State:FL
Practice Address - Zip Code:34741
Practice Address - Country:US
Practice Address - Phone:321-697-1730
Practice Address - Fax:407-518-3923
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-20
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MIME149747207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program