Provider Demographics
NPI:1073589503
Name:ANNULIS, THOMAS MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:MICHAEL
Last Name:ANNULIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7250 PARKWAY DRIVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076
Mailing Address - Country:US
Mailing Address - Phone:443-949-0814
Mailing Address - Fax:443-949-0825
Practice Address - Street 1:100 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PRINCE FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:20678-4017
Practice Address - Country:US
Practice Address - Phone:410-535-4000
Practice Address - Fax:410-535-8224
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0052401208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC52970026OtherCAREFIRST DC
MD54677904OtherCAREFIRST MD
DC018345B16Medicare PIN
MD54677904OtherCAREFIRST MD
MD133617ZA2HMedicare PIN