Provider Demographics
NPI:1205273174
Name:THOMSON, MARY J (MD)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:J
Last Name:THOMSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1500 E MEDICAL CENTER DR
Mailing Address - Street 2:3910Q TAUBMAN CENTER
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:3116 TAUBMAN CENTER, SPC 5368
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-845-5290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-31
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301103181390200000X
MN67051207RT0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RT0003XAllopathic & Osteopathic PhysiciansInternal MedicineTransplant Hepatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program