Provider Demographics
NPI:1144229667
Name:THOMPSON-CHITTAMS, TONI LYNN (DO)
Entity Type:Individual
Prefix:DR
First Name:TONI
Middle Name:LYNN
Last Name:THOMPSON-CHITTAMS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17121 ASPEN LEAF DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-3643
Mailing Address - Country:US
Mailing Address - Phone:301-352-3821
Mailing Address - Fax:
Practice Address - Street 1:4357 NORTHVIEW DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-2603
Practice Address - Country:US
Practice Address - Phone:301-352-6515
Practice Address - Fax:301-352-6516
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDH0058746208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDH0058746OtherSTATE LICENSE