Provider Demographics
NPI:1033226204
Name:MAGEE, THOMAS H (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:MAGEE
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 400
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32902
Mailing Address - Country:US
Mailing Address - Phone:321-409-9990
Mailing Address - Fax:321-309-9033
Practice Address - Street 1:709 S HARBOR CITY BLVD STE 100
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32901-1968
Practice Address - Country:US
Practice Address - Phone:321-409-9900
Practice Address - Fax:321-309-9033
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL720432085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1033226204Medicaid
FL262084700Medicaid
PA102220848 0001Medicaid
MD0157392 00Medicaid
AZ232300Medicaid
WA8495293Medicaid
AZ232300Medicaid
IA1033226204Medicaid
WA8495293Medicaid
FLE4931UMedicare PIN