Provider Demographics
NPI:1417926395
Name:FITHIAN, THOMAS EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:EDWARD
Last Name:FITHIAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:730 THIMBLE SHOALS BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4562
Mailing Address - Country:US
Mailing Address - Phone:757-873-1554
Mailing Address - Fax:757-873-3239
Practice Address - Street 1:730 THIMBLE SHOALS BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4562
Practice Address - Country:US
Practice Address - Phone:757-873-1554
Practice Address - Fax:757-873-3239
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101036311207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA54-1869550OtherTRICARE/CHAMPUS
VA4364388OtherAETNA
VA64-0565-7Medicaid
VA021323OtherCIGNA
VA336138OtherMAMSI
VA0900341OtherUNITED HEALTHCARE
VA425372OtherSOUTHERN HEALTH SERVICES
VA51704OtherSENTARA HMO/PPO
VA323658OtherBLUE CROSS BLUE SHIELD
VA541869550OtherVIRGINIA HEALTH NETWORK
VA541869550OtherMULTIPLAN
VA425372OtherUNITED HEALTHCARE
VA541869550OtherPHCS
VA200029952OtherMEDICARE RAILROAD
VA323658OtherBLUE CROSS BLUE SHIELD
VA541869550OtherPHCS
VA425372OtherUNITED HEALTHCARE