Doctor Name: | DR. IRVIN ISRAEL THOMAS |
NPI Number: | 1235171109 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | D0055356 |
Business Practice Address: | 7300 Van Dusen Rd Laurel, MD - 207079463 |
Business Phone Number: | 3017254300 |
Business Fax Number: | |
Mailing Address: | 18414 Polynesian Ln, BOYDS |
State: | MD |
Postal Code: | 208414312 |
Phone Number: | 3019166309 |
Fax Number: | |
NPI Enumeration Date: | 06/12/2006 |
NPI Last Update Date: | 01/10/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | D0055356 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MD |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |