Provider Demographics
NPI:1871665430
Name:THAMARUS, WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:WARREN
Middle Name:
Last Name:THAMARUS
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:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-1239
Mailing Address - Country:US
Mailing Address - Phone:248-824-6600
Mailing Address - Fax:
Practice Address - Street 1:7800 SHOAL CREEK BLVD
Practice Address - Street 2:SUITE 120W
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1098
Practice Address - Country:US
Practice Address - Phone:512-407-8880
Practice Address - Fax:512-407-8681
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG1216207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine