Provider Demographics
NPI:1235205378
Name:AZMAN, THOMAS (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:AZMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 YORK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3140
Mailing Address - Country:US
Mailing Address - Phone:410-561-8050
Mailing Address - Fax:410-561-8055
Practice Address - Street 1:2219 YORK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3139
Practice Address - Country:US
Practice Address - Phone:410-561-8050
Practice Address - Fax:410-561-8055
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD678152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist