Provider Demographics
NPI:1427085836
Name:MOHS, THOMAS J (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:MOHS
Suffix:
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 1:275 11TH ST S
Mailing Address - Street 2:
Mailing Address - City:WAHPETON
Mailing Address - State:ND
Mailing Address - Zip Code:58075-4655
Mailing Address - Country:US
Mailing Address - Phone:701-642-2000
Mailing Address - Fax:701-671-4106
Practice Address - Street 1:275 11TH ST S
Practice Address - Street 2:
Practice Address - City:WAHPETON
Practice Address - State:ND
Practice Address - Zip Code:58075-4655
Practice Address - Country:US
Practice Address - Phone:701-642-2000
Practice Address - Fax:701-671-4106
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2011-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND7456208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND14516OtherNDBS #
ND30Q14MOOtherMNBS #
NDHP25809OtherHEALTHPARTNERS #
ND68D42MOOtherMNBS #
ND764743OtherAMERICA'S PPO/ARAZ #
ND1700489OtherMEDICA #
ND18807Medicaid
NDDA9051015627OtherPREFERRED ONE #
ND142040OtherUCARE #
ND963517300Medicaid
ND29T29MOOtherMNBS #
ND1700488OtherMEDICA #
ND13984OtherNDBS #
ND21402OtherSIOUX VALLEY #
ND13984Medicare ID - Type UnspecifiedND MEDICARE #
ND020030849Medicare ID - Type UnspecifiedRR MEDICARE #
ND14156Medicare ID - Type UnspecifiedND MEDICARE #
ND764743OtherAMERICA'S PPO/ARAZ #
ND13984OtherNDBS #
ND30Q14MOOtherMNBS #