Provider Demographics
NPI:1710982269
Name:LHEUREAU, THOMAS VERO (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:VERO
Last Name:LHEUREAU
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 1:651 COLLIERS WAY
Mailing Address - Street 2:SUITE 312
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-5053
Mailing Address - Country:US
Mailing Address - Phone:304-914-4250
Mailing Address - Fax:304-914-4255
Practice Address - Street 1:651 COLLIERS WAY
Practice Address - Street 2:SUITE 312
Practice Address - City:WEIRTON
Practice Address - State:WV
Practice Address - Zip Code:26062-5053
Practice Address - Country:US
Practice Address - Phone:304-914-4250
Practice Address - Fax:304-914-4255
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-20
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-6086-L208600000X
PAMD067526L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018978200002Medicaid
WV7300208000Medicaid
OH2126998Medicaid
PA0018978200001Medicaid
PA100019NJ8Medicare PIN
OH2126998Medicaid
PA0018978200002Medicaid
WV7300208000Medicaid
OHP00306780Medicare PIN
OHLH0876523Medicare PIN