Provider Demographics
NPI:1578575650
Name:THOMAS, MICHELLE PAO (MD, MSC, FACS)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:PAO
Last Name:THOMAS
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Gender:F
Credentials:MD, MSC, FACS
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Mailing Address - Street 1:3340 PROVIDENCE DR
Mailing Address - Street 2:SUITE 359
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4616
Mailing Address - Country:US
Mailing Address - Phone:907-644-1033
Mailing Address - Fax:907-644-0764
Practice Address - Street 1:3340 PROVIDENCE DR
Practice Address - Street 2:SUITE 359
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4616
Practice Address - Country:US
Practice Address - Phone:907-644-1033
Practice Address - Fax:907-644-0764
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AK2563 AK208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD2563Medicaid
AKMD2563Medicaid
AKK164877Medicare Oscar/Certification
AKBY4863280OtherDEA