Provider Demographics
NPI:1194135186
Name:THAMER MEDICAL PLLC
Entity type:Organization
Organization Name:THAMER MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAWAD
Authorized Official - Middle Name:
Authorized Official - Last Name:THAMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-561-8796
Mailing Address - Street 1:2040 MONROE ST
Mailing Address - Street 2:SUITE 206
Mailing Address - City:DEARBORN
Mailing Address - State:MI
Mailing Address - Zip Code:48124-2950
Mailing Address - Country:US
Mailing Address - Phone:313-561-8796
Mailing Address - Fax:313-561-0277
Practice Address - Street 1:2040 MONROE ST
Practice Address - Street 2:SUITE 206
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-2950
Practice Address - Country:US
Practice Address - Phone:313-561-8796
Practice Address - Fax:313-561-0277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-30
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301080367207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty