Provider Demographics
NPI:1861430712
Name:MAGER, THOMAS (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:MAGER
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 1649
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44309-1649
Mailing Address - Country:US
Mailing Address - Phone:330-563-0618
Mailing Address - Fax:330-563-0605
Practice Address - Street 1:525 E MARKET ST
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1619
Practice Address - Country:US
Practice Address - Phone:330-375-3369
Practice Address - Fax:330-375-3769
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-03
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084225207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341779226003OtherMED MUT OF OH/ 2 OF 3
OH61641OtherUNITED HEALTHCARE
OHP00125972OtherRR MEDICARE
OH341779226002OtherMED MUT OF OHIO/ 1 OF 3
OH341779226006OtherMED MUT OF OH/ 3 OF 3
OH000000336136OtherANTHEM
OH341779226TMOtherSUMMACARE
OH2501911Medicaid
OH341779226006OtherMED MUT OF OH/ 3 OF 3
OH4132273Medicare ID - Type Unspecified3 OF 3
OH341779226TMOtherSUMMACARE
OH341779226003OtherMED MUT OF OH/ 2 OF 3