Provider Demographics
NPI:1104010214
Name:THOMAS, RICHARD WILLIAM (MD, DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:WILLIAM
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD, DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4301 JONES BRIDGE RD
Mailing Address - Street 2:OFFICE OF THE PRESIDENT
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-4712
Mailing Address - Country:US
Mailing Address - Phone:301-295-3013
Mailing Address - Fax:
Practice Address - Street 1:111 ARMY PENTAGON
Practice Address - Street 2:ROOM 2E461
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20310-0111
Practice Address - Country:US
Practice Address - Phone:703-693-1909
Practice Address - Fax:703-693-7072
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-31
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00038094207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery