Provider Demographics
NPI:1609828318
Name:THOMAS, H. EMERSON JR (MD)
Entity Type:Individual
Prefix:
First Name:H.
Middle Name:EMERSON
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 1:212 HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02050-6217
Mailing Address - Country:US
Mailing Address - Phone:781-837-3323
Mailing Address - Fax:
Practice Address - Street 1:780 BOYLSTON ST
Practice Address - Street 2:PLAZA LEVEL
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02199-7820
Practice Address - Country:US
Practice Address - Phone:617-262-1500
Practice Address - Fax:617-262-7015
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA27888207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0187623Medicaid
MAB75545Medicare UPIN
MA0187623Medicaid