Thomas G Pelz, DO
Individual provider Active NPI Internal Medicine Physician · Boscobel, WI
NPI 1760490262 · NPPES record last updated May 5, 2008
Key facts
- NPI
- 1760490262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 25166 (WI)
- Practice address
- 200 W Bluff St
Boscobel, WI 53805-1601 - Phone
- (608) 375-2424
- Fax
- (608) 375-6285
- NPI assigned
- Aug 3, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 25166 | WI | Yes |
Addresses
Primary practice location
200 W Bluff St
Boscobel, WI 53805-1601
Mailing address
205 Parker St
Boscobel, WI 53805-1642
Phone (608) 375-6217
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30019400 | Medicaid | WI |
Other providers in Boscobel, WI
- Robyn Ann Moritz
- Movement Redefined Spine and Sport - Boscobel LLC
- Haley Mueller
- Keith W. Nance
- Catherine R Neff
- Carol Sharon Piraino
- Premier Spine - Boscobel LLC
- Rebecca Miller LLC
- Jennifer S Reink
- Maggie Reynolds
All providers in Boscobel, WI · Internal Medicine Physician in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 5, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.