Paholak, Thomas Daniel

Paholak, Thomas Daniel is an individual health care provider with primary practice located at 12786 Lasalle Ln , Huntington Woods MI 48070-1020. He recently has 2 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Podiatrist is his primary health care specialty. Paholak, Thomas Daniel can be contacted via phone (248) 572-3900.

Contact Information

Primary practice address
12786 Lasalle Ln Huntington Woods MI 48070-1020
Phone: (248) 572-3900
Fax: (248) 572-1277
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 016004340 Illinois
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X 016-004340 Illinois
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 5901001714 Michigan

Profile Details

NPI number 1710934955
LBN Legal business name Paholak, Thomas Daniel
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 No
Enumeration date May 30th, 2006
Last updated Mar 23rd, 2022 - about 2 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 1710934955 NPPES
Illinois Other 016-004340 IL STATE LICENSE
Illinois Other 0001623503 IL STATE LICENSE
Illinois MEDICAID 016-004340 IL STATE LICENSE
Illinois Other 480027688 IL STATE LICENSE

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