Provider Demographics
NPI:1568443786
Name:THOMAS, ADEEB E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ADEEB
Middle Name:E
Last Name:THOMAS
Suffix:JR
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 1:1430 GADSDEN HWY
Mailing Address - Street 2:SUITE 112
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3103
Mailing Address - Country:US
Mailing Address - Phone:205-661-0003
Mailing Address - Fax:
Practice Address - Street 1:1430 GADSDEN HWY
Practice Address - Street 2:SUITE 112
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3103
Practice Address - Country:US
Practice Address - Phone:205-661-0003
Practice Address - Fax:205-661-3017
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2015-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL15172207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000099270Medicaid
ALE47821Medicare UPIN
AL000099270Medicare ID - Type UnspecifiedALABAMA MEDICARE #