Provider Demographics
NPI:1194775205
Name:ROHS, THOMAS JOSEPH JR (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JOSEPH
Last Name:ROHS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 SHAFFER ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1647
Mailing Address - Country:US
Mailing Address - Phone:269-343-9113
Mailing Address - Fax:269-343-0510
Practice Address - Street 1:1717 SHAFFER ST
Practice Address - Street 2:SUITE 108
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1647
Practice Address - Country:US
Practice Address - Phone:269-343-9113
Practice Address - Fax:269-343-0510
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301060374208600000X, 2086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4166777Medicaid
MI0203904022OtherBCBSM
MI0C97625111Medicare PIN
MI0203904022OtherBCBSM
0M92070Medicare ID - Type Unspecified