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OIG exclusion detail

THUMB PHYSICAL MEDICINE AND RE

This page shows an imported LEIE row. Verify details against the official OIG source before acting.

Imported OIG rowOfficial OIG source
NPI
1104129303
Name
THUMB PHYSICAL MEDICINE AND RE
Address
1117 S VAN DYKE RD, STE 100, BAD AXE, MI, 48413
Specialty
GENERAL PRACTICE
Exclusion type
1128b8
Exclusion date
20140520
Reinstatement date
00000000
Waiver
00000000

Source snapshot

Imported: May 05, 2026

Rows: 83,001

Checksum: 3a10b8ee0e4691855f74ce65a5e733672474291f79ed1f7cef163328d945e9a7

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