Provider Demographics
NPI:1144203829
Name:THOMAS, ANN MARIE S (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN MARIE
Middle Name:S
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9142
Mailing Address - Street 2:
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-9142
Mailing Address - Country:US
Mailing Address - Phone:617-573-2200
Mailing Address - Fax:617-573-2769
Practice Address - Street 1:311 SERVICE RD # SRH
Practice Address - Street 2:
Practice Address - City:EAST SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02537-1370
Practice Address - Country:US
Practice Address - Phone:508-833-4000
Practice Address - Fax:508-833-4202
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153814207R00000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAJ17591OtherBCBS MA
MA3165604Medicaid
MA771983OtherTUFTS HEALTH PLAN
MAA22343Medicare ID - Type Unspecified
G45076Medicare UPIN