Doctor Name: | PENDLETON EMMETT THOMAS |
NPI Number: | 1144342247 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 12269 |
Business Practice Address: | 6200 Manaford Cir Glen Allen, VA - 230597031 |
Business Phone Number: | 8043646573 |
Business Fax Number: | 8043646573 |
Mailing Address: | 6200 Manaford Cir, GLEN ALLEN |
State: | VA |
Postal Code: | 230597031 |
Phone Number: | 8043646573 |
Fax Number: | 8043646573 |
NPI Enumeration Date: | 04/06/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | 12269 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |