Provider Demographics
NPI:1447258637
Name:VATES, THOMAS SCHUMANN (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:SCHUMANN
Last Name:VATES
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 1:557 CRANBURY RD
Mailing Address - Street 2:STE 4
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-5419
Mailing Address - Country:US
Mailing Address - Phone:732-613-9144
Mailing Address - Fax:732-613-5121
Practice Address - Street 1:557 CRANBURY RD
Practice Address - Street 2:STE 4
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-5419
Practice Address - Country:US
Practice Address - Phone:732-613-9144
Practice Address - Fax:732-613-5121
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2012-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA056477002088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA909560Medicare ID - Type Unspecified
G50259Medicare UPIN