Provider Demographics
NPI:1528002706
Name:THOMAS, ANDREW W (MD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:W
Last Name:THOMAS
Suffix:
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 1:28 MEETINGHOUSE LN
Mailing Address - Street 2:
Mailing Address - City:BRADFORDWOODS
Mailing Address - State:PA
Mailing Address - Zip Code:15015-1311
Mailing Address - Country:US
Mailing Address - Phone:412-318-0075
Mailing Address - Fax:412-318-0081
Practice Address - Street 1:3285 BABCOCK BLVD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15237-2829
Practice Address - Country:US
Practice Address - Phone:412-318-0075
Practice Address - Fax:412-318-0081
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD049296L174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0015853400003Medicaid
PA865663OtherBLUE CROSS BLUE SHIELD
PA1500804OtherGATEWAY
PA154887OtherHEALTH AMERICA
PA2174223OtherUS HEALTHCARE
PA154887OtherHEALTH AMERICA
PA0015853400003Medicaid