1588779862 NPI number — DR. THOMAS JOSEPH ANTHONY M.D.

Table of content: DR. THOMAS JOSEPH ANTHONY M.D. (NPI 1588779862)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588779862 NPI number — DR. THOMAS JOSEPH ANTHONY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANTHONY
Provider First Name:
THOMAS
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588779862
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14014 LOBLOLLY TER
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCKVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20850-5472
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-593-7510
Provider Business Mailing Address Fax Number:
301-593-7572

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9801 GEORGIA AVE
Provider Second Line Business Practice Location Address:
#116
Provider Business Practice Location Address City Name:
SILVER SPRING
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20902-5276
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-593-7510
Provider Business Practice Location Address Fax Number:
301-593-7572
Provider Enumeration Date:
08/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RI0011X , with the licence number:  D50300 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5005384 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1090337 . This is a "CIGNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: J627-0001 . This is a "BC/BS NATIONAL CAPITAL AR" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 642ATH 543613-02 . This is a "BC/BS MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 883901800 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 439890 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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