Provider Demographics
NPI:1972034452
Name:BOHMAN, THOMAS D (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:D
Last Name:BOHMAN
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 1:18 MDG, UNIT 5268
Mailing Address - Street 2:OPC 80, BOX 5217
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96368-5217
Mailing Address - Country:US
Mailing Address - Phone:315-630-4780
Mailing Address - Fax:
Practice Address - Street 1:18 MDG, KADENA AB, UNIT 5268
Practice Address - Street 2:OPC 80, BOX 5217
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96368-5217
Practice Address - Country:US
Practice Address - Phone:315-630-4780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-25
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE314002084P0800X, 208D00000X
AK1797672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice