Provider Demographics
NPI:1457623977
Name:MEHALIC, THOMAS FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:FRANCIS
Last Name:MEHALIC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1605 MIDDLE GULF DRIVE
Mailing Address - Street 2:UNIT 315
Mailing Address - City:SANIBEL
Mailing Address - State:FL
Mailing Address - Zip Code:33957-7605
Mailing Address - Country:US
Mailing Address - Phone:239-395-3438
Mailing Address - Fax:239-395-1621
Practice Address - Street 1:1605 MIDDLE GULF DRIVE
Practice Address - Street 2:UNIT 315
Practice Address - City:SANIBEL
Practice Address - State:FL
Practice Address - Zip Code:33957-7605
Practice Address - Country:US
Practice Address - Phone:239-395-3438
Practice Address - Fax:239-395-1621
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-30
Last Update Date:2012-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME009226207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery