Provider Demographics
NPI:1710955349
Name:DOWNHAM, THOMAS F II (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:F
Last Name:DOWNHAM
Suffix:II
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 1:24555 HAIG ST
Mailing Address - Street 2:
Mailing Address - City:TAYLOR
Mailing Address - State:MI
Mailing Address - Zip Code:48180-3322
Mailing Address - Country:US
Mailing Address - Phone:313-375-2101
Mailing Address - Fax:313-375-2140
Practice Address - Street 1:24555 HAIG ST
Practice Address - Street 2:
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-3322
Practice Address - Country:US
Practice Address - Phone:313-375-2101
Practice Address - Fax:313-375-2140
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301030099207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2577227Medicaid
MI2577227Medicaid
MIF01782Medicare UPIN