Provider Demographics
NPI:1225234891
Name:THOMAS, MATHEW A (MD)
Entity Type:Individual
Prefix:DR
First Name:MATHEW
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-0845
Mailing Address - Country:US
Mailing Address - Phone:410-569-5155
Mailing Address - Fax:410-569-5166
Practice Address - Street 1:2012 S TOLLGATE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-5900
Practice Address - Country:US
Practice Address - Phone:410-569-5155
Practice Address - Fax:410-569-5166
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2013-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAL-2250772086S0122X
MDD745992086S0122X
MDD0074599207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery