Provider Demographics
NPI:1558351627
Name:ZANDERS, THOMAS BRUCE (DO, FACP)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BRUCE
Last Name:ZANDERS
Suffix:
Gender:M
Credentials:DO, FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 DELAWARE AVE
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILL
Mailing Address - State:PA
Mailing Address - Zip Code:18015-1107
Mailing Address - Country:US
Mailing Address - Phone:484-526-3890
Mailing Address - Fax:866-829-8936
Practice Address - Street 1:709 DELAWARE AVE
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILL
Practice Address - State:PA
Practice Address - Zip Code:18015-1107
Practice Address - Country:US
Practice Address - Phone:484-526-3890
Practice Address - Fax:866-829-8936
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2017-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC2-0007275207R00000X
PAOS016291207R00000X, 207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA275503OtherMEDICARE
PA2862489OtherBLUE SHIELD
PA102802860Medicaid