Provider Demographics
NPI:1043412935
Name:THOMAS, OWEN C (MD)
Entity Type:Individual
Prefix:DR
First Name:OWEN
Middle Name:C
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-0497
Mailing Address - Country:US
Mailing Address - Phone:302-645-3775
Mailing Address - Fax:302-645-3774
Practice Address - Street 1:18947 JOHN J WILLIAMS HWY UNIT 101
Practice Address - Street 2:
Practice Address - City:REHOBOTH BEACH
Practice Address - State:DE
Practice Address - Zip Code:19971-4480
Practice Address - Country:US
Practice Address - Phone:302-645-3775
Practice Address - Fax:302-645-3774
Is Sole Proprietor?:No
Enumeration Date:2007-06-03
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DEC100100862085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
244239YFK3Medicare PIN