Provider Demographics
NPI:1407831696
Name:DEMARINI, THOMAS PATRICK (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:PATRICK
Last Name:DEMARINI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2665 N DECATUR RD
Mailing Address - Street 2:STE 430
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6145
Mailing Address - Country:US
Mailing Address - Phone:404-294-4018
Mailing Address - Fax:404-294-9161
Practice Address - Street 1:2665 N DECATUR RD
Practice Address - Street 2:STE 430
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6145
Practice Address - Country:US
Practice Address - Phone:404-294-4018
Practice Address - Fax:404-294-1359
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2010-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA032171207RP1001X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0932200001OtherWORKERS COMPENSATION
4806430OtherUNITED HEALTHCARE
4092541OtherAETNA
GA00403356CMedicaid
GA1407831696OtherNPI
GA264495OtherBLUE CROSS BLUE SHIELD
GA5930OtherKAISER
2138458010OtherCIGNA
GA110093072OtherRAILROAD MEDICARE
2999931OtherGHI
C44566Medicare UPIN
4806430OtherUNITED HEALTHCARE