Provider Demographics
NPI:1366501066
Name:GARVEY III, THOMAS Q (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:Q
Last Name:GARVEY III
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10125 GARY RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4109
Mailing Address - Country:US
Mailing Address - Phone:301-299-3431
Mailing Address - Fax:301-299-5931
Practice Address - Street 1:11510 OLD GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2736
Practice Address - Country:US
Practice Address - Phone:301-881-3940
Practice Address - Fax:301-230-2635
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0020301207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDC88725Medicare UPIN