Provider Demographics
NPI:1629002183
Name:WINTER, THOMAS WARD (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:WARD
Last Name:WINTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1884 STOWE AVE
Mailing Address - Street 2:
Mailing Address - City:ARDEN HILLS
Mailing Address - State:MN
Mailing Address - Zip Code:55112-7810
Mailing Address - Country:US
Mailing Address - Phone:651-633-4365
Mailing Address - Fax:
Practice Address - Street 1:2300 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55105-1137
Practice Address - Country:US
Practice Address - Phone:651-241-8436
Practice Address - Fax:651-241-2793
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26621207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine