Tietjen, Thomas
Tietjen, Thomas is an individual health care provider with primary practice located at 560 W Mitchell St Suite M40, Petoskey MI 49770-2278. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Tietjen, Thomas can be contacted via phone (231) 487-2391.Contact Information
Primary practice address
560 W Mitchell St Suite M40
Petoskey MI 49770-2278
Phone: (231) 487-2391
Fax: (231) 487-6513
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | TT077247 | Michigan |
Profile Details
| NPI number | 1861553026 |
|---|---|
| LBN Legal business name | Tietjen, Thomas |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 12th, 2006 |
| Last updated | Dec 24th, 2015 - about 11 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 | 1861553026 | NPPES |
| Michigan | MEDICAID | 1861553026 |
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