Thomas, Bryon Wesley
Thomas, Bryon Wesley is an individual health care provider with primary practice located at 303 S Main St Suite 212, Mishawaka IN 46544-2189. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Thomas, Bryon Wesley can be contacted via phone (574) 254-0800.Contact Information
Primary practice address
303 S Main St Suite 212
Mishawaka IN 46544-2189
Phone: (574) 254-0800
Fax: (574) 254-0812
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 01052749 | Indiana |
Profile Details
| NPI number | 1497794010 |
|---|---|
| LBN Legal business name | Thomas, Bryon Wesley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Aug 29th, 2012 - about 12 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 | 1497794010 | NPPES |
| Indiana | MEDICAID | 200290600A |
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