Dunham, Thomas Stephen

Dunham, Thomas Stephen is an individual health care provider with primary practice located at 3035 Demers Ave , Grand Forks ND 58201-4040. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Dunham, Thomas Stephen can be contacted via phone (701) 775-3151.

Contact Information

Primary practice address
3035 Demers Ave Grand Forks ND 58201-4040
Phone: (701) 775-3151
Fax: (701) 775-3153
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 421 North Dakota

Profile Details

NPI number 1982601357
LBN Legal business name Dunham, Thomas Stephen
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Jun 23rd, 2014 - about 10 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 1982601357 NPPES
Other 870421 G2 VSI
MEDICAID 60300 VSI
MEDICAID 00568 VSI

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