Provider Demographics
NPI:1427042043
Name:THOMAS, ALBERT BRUCE II (MD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:BRUCE
Last Name:THOMAS
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46165 WESTLAKE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5872
Mailing Address - Country:US
Mailing Address - Phone:703-433-1700
Mailing Address - Fax:
Practice Address - Street 1:46165 WESTLAKE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5872
Practice Address - Country:US
Practice Address - Phone:703-433-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-09
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049657208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA06802222Medicaid
VA250012095OtherRR MEDICARE
G19875Medicare UPIN
VA250012095OtherRR MEDICARE