Provider Demographics
NPI:1851341846
Name:CHI, THOMAS SK (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:SK
Last Name:CHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3583 RESERVE COMMONS DR
Mailing Address - Street 2:
Mailing Address - City:MEDINA
Mailing Address - State:OH
Mailing Address - Zip Code:44256-8180
Mailing Address - Country:US
Mailing Address - Phone:330-722-8300
Mailing Address - Fax:330-725-0445
Practice Address - Street 1:3583 RESERVE COMMONS DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8180
Practice Address - Country:US
Practice Address - Phone:330-722-8300
Practice Address - Fax:330-725-0445
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2008-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35066729207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000234687OtherUNISON
OH000000292122OtherANTHEM
OH000000558044OtherANTHEM
OH0979277Medicaid
OH5747830001Medicare NSC
OH000000234687OtherUNISON
F63690Medicare UPIN
OH000000558044OtherANTHEM