Provider Demographics
NPI:1891344073
Name:THOMAS, MARIAN (CAREGIVER)
Entity Type:Individual
Prefix:MS
First Name:MARIAN
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:CAREGIVER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9250 S 29TH ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTS
Mailing Address - State:MI
Mailing Address - Zip Code:49088
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9250 S 29TH ST
Practice Address - Street 2:
Practice Address - City:SCOTTS
Practice Address - State:MI
Practice Address - Zip Code:49088
Practice Address - Country:US
Practice Address - Phone:269-327-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2019-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider