Provider Demographics
NPI:1508124082
Name:THOMAS MAYS MD , PC
Entity Type:Organization
Organization Name:THOMAS MAYS MD , PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-559-5760
Mailing Address - Street 1:20905 GREENFIELD RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5346
Mailing Address - Country:US
Mailing Address - Phone:248-559-5760
Mailing Address - Fax:248-559-5005
Practice Address - Street 1:20905 GREENFIELD RD STE 201
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5346
Practice Address - Country:US
Practice Address - Phone:248-559-5760
Practice Address - Fax:248-559-5005
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MITM043030207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1255344339Medicaid
MI1255344339Medicaid