Provider Demographics
NPI:1992101208
Name:THOMAS, SANJA
Entity type:Individual
Prefix:
First Name:SANJA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22930 NADYNE
Mailing Address - Street 2:
Mailing Address - City:BROWNSTOWN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48183-1417
Mailing Address - Country:US
Mailing Address - Phone:734-512-6493
Mailing Address - Fax:
Practice Address - Street 1:22930 NADYNE
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-1417
Practice Address - Country:US
Practice Address - Phone:734-512-6493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-13
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No175T00000XOther Service ProvidersPeer Specialist