Mushong, Thomas M

Mushong, Thomas M is an individual health care provider with primary practice located at 100 Michigan St Ne , Grand Rapids MI 49503-2560. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Mushong, Thomas M can be contacted via phone (616) 391-1680.

Contact Information

Primary practice address
100 Michigan St Ne Grand Rapids MI 49503-2560
Phone: (616) 391-1680
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X 5601003863 Michigan
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 5601003863 Michigan

Profile Details

NPI number 1699749366
LBN Legal business name Mushong, Thomas M
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Sep 4th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699749366 NPPES
Michigan Other 110D111790 BCBSM
Michigan Other P00397289 BCBSM

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