Provider Demographics
NPI:1750325775
Name:CASALE, THOMAS GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GERARD
Last Name:CASALE
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 1:215 E MANSION ST
Mailing Address - Street 2:SUITE 3E
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1559
Mailing Address - Country:US
Mailing Address - Phone:269-781-4267
Mailing Address - Fax:269-781-2710
Practice Address - Street 1:215 E MANSION ST
Practice Address - Street 2:SUITE 3E
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1559
Practice Address - Country:US
Practice Address - Phone:269-781-4267
Practice Address - Fax:269-781-2710
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MITC060148174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI020A312720OtherBCBSM GROUP ID
MI4248946Medicaid
MI4848946Medicaid
MI0M98600015Medicare PIN
MIG42290Medicare UPIN
MI4248946Medicaid
MI4848946Medicaid