Provider Demographics
NPI:1346323797
Name:THOMAS, SUMESH (PT)
Entity Type:Individual
Prefix:DR
First Name:SUMESH
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5535 HARFORD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-2233
Mailing Address - Country:US
Mailing Address - Phone:410-444-2770
Mailing Address - Fax:410-444-2772
Practice Address - Street 1:5535 HARFORD RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-2233
Practice Address - Country:US
Practice Address - Phone:410-444-2770
Practice Address - Fax:410-444-2772
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD19036225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD121N026GMedicare PIN