Poulin, Thomas L
Poulin, Thomas L is an individual health care provider with primary practice located at 100 Navarre Pl Ste 5500 , South Bend IN 46601-1172. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Poulin, Thomas L can be contacted via phone (574) 647-5200.Contact Information
Primary practice address
100 Navarre Pl Ste 5500
South Bend IN 46601-1172
Phone: (574) 647-5200
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 01023972A | Indiana |
Profile Details
| NPI number | 1497732556 |
|---|---|
| LBN Legal business name | Poulin, Thomas L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 29th, 2005 |
| Last updated | Mar 31st, 2021 - about 4 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1497732556 | NPPES |
| Indiana | MEDICAID | 100222350 |
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