Mark William Thomas, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301076069 Issued in MI

Practice address

7210 N Main St Ste 205
Clarkston, MI 48346-1575

Phone

(248) 625-9755

Fax

(248) 620-9334

NPI assigned

Jul 25, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premiere Pediatrics, PC

  • Pediatrics Physician
  • Clarkston, MI
  • NPI 1134291982
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1750304796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19186 CHELTON DR",
            "city": "BEVERLY HILLS",
            "state": "MI",
            "postal_code": "480255212",
            "telephone_number": "248-625-9755",
            "fax_number": "248-620-9334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7210 N MAIN ST STE 205",
            "city": "CLARKSTON",
            "state": "MI",
            "postal_code": "483461575",
            "telephone_number": "248-625-9755",
            "fax_number": "248-620-9334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "MARK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "170100000X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Ph.D. Medical Genetics",
            "state": "MI",
            "license": "4301076069",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301076069",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas G. Santarossa DDS PC
• Alysa Thomas
• David William Thomas, DO
• Gabriella Thomas
• Kenneth Delwyn Thomas, DDS
• Matthew Bryson Thomas, DDS
• Paula Thomas
• Scott Steven Thomas, D.C.
• Theresa M Thomas, D.O.
• Chelsea Thompson

• Pediatrics Physician in Clarkston, MI
• Providers in Clarkston, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.