Wayne, Thomas Gordon

Wayne, Thomas Gordon is an individual health care provider with primary practice located at 4150 S River Rd Ste F1, East China MI 48054. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Wayne, Thomas Gordon can be contacted via phone (810) 326-0858.

Contact Information

Primary practice address
4150 S River Rd Ste F1 East China MI 48054
Phone: (810) 326-0858
Fax: (810) 326-0933
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 4301047530 Michigan

Profile Details

NPI number 1861415754
LBN Legal business name Wayne, Thomas Gordon
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 25th, 2006
Last updated Sep 30th, 2020 - about 6 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 1861415754 NPPES
Michigan MEDICAID 4277711
Michigan Other 0807408272

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