Provider Demographics
NPI:1598729774
Name:ZUESI, THOMAS JAMS (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JAMS
Last Name:ZUESI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5777 GREENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:GALENA
Mailing Address - State:OH
Mailing Address - Zip Code:43021-9005
Mailing Address - Country:US
Mailing Address - Phone:740-657-8112
Mailing Address - Fax:
Practice Address - Street 1:561 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1410
Practice Address - Country:US
Practice Address - Phone:740-615-1169
Practice Address - Fax:740-615-1173
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2010-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34006810207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000032022OtherBCBS
930107629OtherRR MCR
OH2179208Medicaid
OHP00092773OtherRR MEDICARE # AT GRADY
OH000000317010OtherBC/BS # AT GRADY
OH000000032022OtherBCBS
OH000000317010OtherBC/BS # AT GRADY
OH4146818Medicare PIN
OH0875329Medicare PIN
OHG93112Medicare UPIN
930107629OtherRR MCR
OH4146811Medicare PIN