Provider Demographics
NPI:1043318538
Name:THOMAS, DORIANN R (MD)
Entity Type:Individual
Prefix:
First Name:DORIANN
Middle Name:R
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 9200
Mailing Address - Street 2:DEPT 6
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-9200
Mailing Address - Country:US
Mailing Address - Phone:301-725-5398
Mailing Address - Fax:301-725-8968
Practice Address - Street 1:7350 VAN DUSEN RD
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5263
Practice Address - Country:US
Practice Address - Phone:301-725-5398
Practice Address - Fax:301-725-8968
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00448952085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDP00225808Medicare PIN
DCG02054C01Medicare PIN