Provider Demographics
NPI:1235157348
Name:THOMAS, STEVEN S (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:S
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2185 NORTHLAKE PKWY
Mailing Address - Street 2:SUITE 104
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4126
Mailing Address - Country:US
Mailing Address - Phone:770-934-7200
Mailing Address - Fax:770-934-7243
Practice Address - Street 1:2185 NORTHLAKE PKWY
Practice Address - Street 2:SUITE 104
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4126
Practice Address - Country:US
Practice Address - Phone:770-934-7200
Practice Address - Fax:770-934-7243
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA21834207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
029499OtherBLUE CROSS/BS
GA00282884CMedicaid
029499OtherBLUE CROSS/BS