Provider Demographics
NPI:1932136652
Name:REMINGA, THOMAS A (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:REMINGA
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 1:1522 N PROSPECT AVE UNIT 1302
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-6525
Mailing Address - Country:US
Mailing Address - Phone:414-573-0007
Mailing Address - Fax:
Practice Address - Street 1:1522 N PROSPECT AVE UNIT 1302
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-6525
Practice Address - Country:US
Practice Address - Phone:414-573-0007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-27
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20168-202083P0901X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036050138Medicaid
WI930106697OtherMEDICARE RAILROAD
WI30543400Medicaid
WI930044454OtherMEDICARE RAILROAD
WI930068407OtherMEDICARE RAILROAD
WI930070595OtherMEDICARE RAILROAD
WI0005-07660Medicare ID - Type Unspecified
WI930106697OtherMEDICARE RAILROAD
WI001632280Medicare ID - Type Unspecified
WI930068407OtherMEDICARE RAILROAD
WI0007-40115Medicare ID - Type Unspecified
WI0001-01240Medicare ID - Type Unspecified
WI30543400Medicaid
WI0029-01400Medicare ID - Type Unspecified