Provider Demographics
NPI:1427099522
Name:DONOHUE, THOMAS A (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:DONOHUE
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:PO BOX 30490
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-0490
Mailing Address - Country:US
Mailing Address - Phone:912-232-9700
Mailing Address - Fax:912-232-9701
Practice Address - Street 1:5356 REYNOLDS ST
Practice Address - Street 2:201
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-6016
Practice Address - Country:US
Practice Address - Phone:912-819-8187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27327207P00000X
GA048889207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000888599LMedicaid
GA52820215-011OtherBCBS GEORGIA
GA000888599AMedicaid
GA000888599DMedicaid
GA10058624OtherAMERIGROUP
GA52820215-001OtherBCBS
SCG48889Medicaid
SCGPA892Medicaid
GA000888599EMedicaid
SC000888599GMedicaid
GA000888599IMedicaid
GA000888599CMedicaid
GA000888599JMedicaid
SCGPA902Medicaid
SCG48889Medicaid
SCH314949222Medicare PIN
GA000888599DMedicaid
GA000888599IMedicaid
SCP00302249Medicare PIN
GA930099416Medicare PIN
GAP00418172Medicare PIN
GA000888599JMedicaid
GA93BDNRZMedicare PIN
GA10058624OtherAMERIGROUP