Provider Demographics
NPI:1376624437
Name:QUALEY, THOMAS FREDERICK (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FREDERICK
Last Name:QUALEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1702 P ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-1326
Mailing Address - Country:US
Mailing Address - Phone:202-210-5833
Mailing Address - Fax:202-463-0220
Practice Address - Street 1:C/O PRICE MEDICAL
Practice Address - Street 2:1330 NEW HAMPSHIRE AVE, NW #121
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036
Practice Address - Country:US
Practice Address - Phone:202-463-0220
Practice Address - Fax:202-463-0222
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
DCMD32275207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCB94299Medicare UPIN