Provider Demographics
NPI:1558583922
Name:TIMA, THOMAS ANTON
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ANTON
Last Name:TIMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15077 SASSAFRAS DR
Mailing Address - Street 2:
Mailing Address - City:STRONGSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44136-1781
Mailing Address - Country:US
Mailing Address - Phone:440-238-2309
Mailing Address - Fax:
Practice Address - Street 1:15077 SASSAFRAS DR
Practice Address - Street 2:
Practice Address - City:STRONGSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44136-1781
Practice Address - Country:US
Practice Address - Phone:440-238-2309
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0900XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMicrobiology