Thomas Richard Bolten (NPI# 1053545707, PAC ID# 6901821875) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORAL SURGERY.
| Nation Provider ID (NPI) | 1053545707 |
| PAC ID by PECOS | 6901821875 |
| Professional Enrollment ID | I20160909001025 |
| Full Name | Thomas Richard Bolten |
| Organization Legal Name | MICHIGAN OMS PC |
| Address |
43900 Garfield Rd Suite 103 Clinton Township MI 48038-1137 |
| Phone Number | 5862289070 |
| Gender | M |
| Medical School | WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 2014 |
| Primary Specialty | ORAL SURGERY |
| Secondary Specialties | MAXILLOFACIAL SURGERY |
| Group Practice PAC ID | 9739084559 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230130 | BEAUMONT HOSPITAL, ROYAL OAK |
| 230029 | ST JOSEPH MERCY OAKLAND |
| Address | Phone | Organization |
|---|---|---|
| 43900 Garfield Rd, Suite 103, Clinton Township, MI 48038-1137 | 5862289070 | MICHIGAN OMS PC |
| 6022 W Maple Rd, Suite 405, West Bloomfield, MI 48322-4408 | 2488552006 | MICHIGAN OMS PC |
| Organization Legal Name | MICHIGAN OMS PC |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Brian C Murphy | Maxillofacial Surgery | Michigan Oms PC | 36610 Heritage Dr, Richmond, MI 48062-1937 |
| Jeffrey S Topf | Maxillofacial Surgery | Michigan Oms PC | 6022 W Maple Rd, Suite 405, West Bloomfield, MI 48322-4408 |
| Nicholas J Bournias | Maxillofacial Surgery | Michigan Oms PC | 43900 Garfield Rd, Suite 103, Clinton Township, MI 48038-1137 |
| Street Address |
43900 GARFIELD RD SUITE 103 |
| City | CLINTON TOWNSHIP |
| State | MI |
| Zip | 48038-1137 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Tanya L Ropes | Nurse Practitioner | St John Providence Physicians Cmg | 43900 Garfield Rd, Suite 222, Clinton Township, MI 48038-1137 |
| Ferah A Dalaly | Internal Medicine | St John Providence Physicians Cmg | 43900 Garfield Rd, Suite 222, Clinton Township, MI 48038-1137 |
| Nicholas J Bournias | Maxillofacial Surgery | Michigan Oms PC | 43900 Garfield Rd, Suite 103, Clinton Township, MI 48038-1137 |
| Michael J Kenneson | Family Medicine | St John Providence Physicians Cmg | 43900 Garfield Rd, Suite 222, Clinton Township, MI 48038-1137 |
| Mary G Veremis Ley | Dermatology | Midwest Center for Dermatology and Pathology Pllc | 43900 Garfield Rd, Suite 100, Clinton Township, MI 48038-1137 |
| Barry I Auster | Dermatology | Midwest Center for Dermatology and Pathology Pllc | 43900 Garfield Rd, Suite 100, Clinton Township, MI 48038-1137 |
| Tiffany K Cukrowski | Dermatology | Midwest Center for Dermatology and Pathology Pllc | 43900 Garfield Rd, Suite 100, Clinton Township, MI 48038-1137 |
| Beena Nagappala | Family Medicine | St John Providence Physicians Cmg | 43900 Garfield Rd, Suite 222, Clinton Township, MI 48038-1137 |
| Kent J Krach | Dermatology | Midwest Center for Dermatology and Pathology Pllc | 43900 Garfield Rd, Suite 100, Clinton Township, MI 48038-1137 |
| Alyssa Miceli | Dermatology | Midwest Center for Dermatology and Pathology Pllc | 43900 Garfield Rd, Suite 100, Clinton Township, MI 48038-1137 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Adam C Schmid | Nurse Practitioner | Advanced Dermatology of Michigan PC | 44003 Partridge Creek Blvd, Clinton Township, MI 48038-0002 |
| Mary G Marji | Nurse Practitioner | Lakeside Urgent Care PC | 44472 Hayes Rd, Clinton Township, MI 48038-1090 |
| Mark Allen Miller | Chiropractic | Family Chiropractor PC. | 44476 Hayes Rd, Clinton Township, MI 48038-1090 |
| Rachel M Klamo | Family Medicine | Lakeside Urgent Care PC | 44472 Hayes Rd, Clinton Township, MI 48038-1090 |
| Jessica Szatkowski | Nurse Practitioner | Lakeside Urgent Care PC | 44472 Hayes Rd, Clinton Township, MI 48038-1090 |
| Suresh Kumar | Internal Medicine | Lakeside Urgent Care PC | 44472 Hayes Rd, Clinton Township, MI 48038-1090 |
| Daymon Peterson | Internal Medicine | Lakeside Urgent Care PC | 44472 Hayes Rd, Clinton Township, MI 48038-1090 |
| Debra A Schmelzer | Physician Assistant | Lakeside Urgent Care PC | 44472 Hayes Rd, Clinton Township, MI 48038-1090 |
| Sarah L Wisniewski | Physician Assistant | Lakeside Urgent Care PC | 44472 Hayes Rd, Clinton Township, MI 48038-1090 |
| Aji Njie | Internal Medicine | Lakeside Urgent Care PC | 44472 Hayes Rd, Clinton Township, MI 48038-1090 |
| Find all physicians in zip 48038 | |||
| City | CLINTON TOWNSHIP |
| Zip Code | 48038 |
| Specialty | ORAL SURGERY |
| City + Specialty | CLINTON TOWNSHIP + ORAL SURGERY |
Please comment or provide details below to improve the information on Thomas Richard Bolten.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.