Provider Demographics
NPI:1265400436
Name:THOMSON, MONICA (DO)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:THOMSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2050 N HAGGERTY RD STE 260
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-3796
Mailing Address - Country:US
Mailing Address - Phone:734-359-5109
Mailing Address - Fax:734-892-2714
Practice Address - Street 1:2050 N HAGGERTY RD STE 260
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187
Practice Address - Country:US
Practice Address - Phone:734-359-5109
Practice Address - Fax:734-892-2714
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101013968207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H90129Medicare UPIN