Thomas Michael Anger, MD
Individual provider Active NPI Pediatrics Physician · St John, IN
NPI 1912908781 · NPPES record last updated May 14, 2010
Key facts
- NPI
- 1912908781
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 01029884 (IN)
- Practice address
- 9660 Wicker Avenue
2ND Floor
St John, IN 46373-9487 - Phone
- (219) 226-2380
- Fax
- (219) 226-2380
- NPI assigned
- Aug 3, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01029884 | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Care Network Inc | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01029884 | IN | Yes |
Addresses
Primary practice location
9660 Wicker Avenue
2ND Floor
St John, IN 46373-9487
Mailing address
9660 Wicker Avenue
2ND Floor
St John, IN 46373-9487
Phone (219) 226-2380
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000081318 | Other | IN | ANTHEM BCBS |
| 100167310B | Medicaid | IN |
Other providers in St John, IN
- David A. Albright
- American Partners LP
- Amore Home Health Care Services, Inc.
- Anderson Eye Care PC
- Valerie Renee Anderson
- Samuel John Arzumanian
- Sarah Ashcraft
- Athletico LTD
- Cortney Baczkowicz
- Daniel Michael Bade
All providers in St John, IN · Pediatrics Physician in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 14, 2010. 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.