Provider Demographics
NPI:1043391618
Name:THOMAS, MARK A (DO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1 FEDERAL ST
Mailing Address - Street 2:STE SW200
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1155
Mailing Address - Country:US
Mailing Address - Phone:856-356-4924
Mailing Address - Fax:
Practice Address - Street 1:1 COOPER PLZ
Practice Address - Street 2:THE COOPER HOSPITALIST TEAM
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1461
Practice Address - Country:US
Practice Address - Phone:856-342-3150
Practice Address - Fax:856-968-8418
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB075505207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
P3686938OtherOXFORD
010005766OtherAMERICHOICE
1080022OtherAETNA
P00281845OtherRR MEDICARE
2231393OtherCIGNA
60020109OtherHORIZON NJ HEALTH
2271167000OtherAMERIHEALTH, KEYSTONE, IBC
38457OtherUNIVERSITY HEALTHPLAN
3K6199OtherHEALTHNET
NJ8077207Medicaid
2362602OtherUNITED HEALTHCARE
G69076Medicare UPIN
NJ8077207Medicaid