Provider Demographics
NPI:1770545964
Name:THAWANI, HEMANT T (MD)
Entity type:Individual
Prefix:
First Name:HEMANT
Middle Name:T
Last Name:THAWANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8359 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-2078
Mailing Address - Country:US
Mailing Address - Phone:810-230-7042
Mailing Address - Fax:810-695-5720
Practice Address - Street 1:9450 S SAGINAW RD
Practice Address - Street 2:SUITE G
Practice Address - City:GRAND BLANC
Practice Address - State:MI
Practice Address - Zip Code:48439-8206
Practice Address - Country:US
Practice Address - Phone:810-603-9391
Practice Address - Fax:810-603-9394
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-04
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301053497207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4802947Medicaid
MI4802947Medicaid
F63478Medicare UPIN