Provider Demographics
NPI:1609829076
Name:TRUEHEART, THOMAS JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JAMES
Last Name:TRUEHEART
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:21700 NORTHWESTERN HWY
Mailing Address - Street 2:SUITE 1290
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4917
Mailing Address - Country:US
Mailing Address - Phone:248-395-2273
Mailing Address - Fax:248-395-3889
Practice Address - Street 1:21700 NORTHWESTERN HWY
Practice Address - Street 2:SUITE 1290
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4917
Practice Address - Country:US
Practice Address - Phone:248-395-2273
Practice Address - Fax:248-395-3889
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301049422207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4628030Medicaid
MI0P00260Medicare ID - Type Unspecified
MI4628030Medicaid