Provider Demographics
NPI:1285626788
Name:THOMAS, DEREK J III (MD)
Entity Type:Individual
Prefix:
First Name:DEREK
Middle Name:J
Last Name:THOMAS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5820 CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3710
Mailing Address - Country:US
Mailing Address - Phone:412-661-5500
Mailing Address - Fax:412-661-4760
Practice Address - Street 1:725 CHERRINGTON PKWY
Practice Address - Street 2:STE 200
Practice Address - City:MOON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15108-4318
Practice Address - Country:US
Practice Address - Phone:412-262-7800
Practice Address - Fax:412-262-2277
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2019-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD426190207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD426190OtherMEDICAL LICENSE
I26860Medicare UPIN