Provider Demographics
NPI:1629395843
Name:THOMAS, MATTHEW WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:WAYNE
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:601 5TH ST S
Mailing Address - Street 2:JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, PEDIATRIC ID
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4804
Mailing Address - Country:US
Mailing Address - Phone:727-767-4160
Mailing Address - Fax:727-767-8270
Practice Address - Street 1:601 5TH ST S
Practice Address - Street 2:JOHNS HOPKINS ALL CHILDREN'S HOSPITAL, PEDIATRIC ID
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4804
Practice Address - Country:US
Practice Address - Phone:727-767-4160
Practice Address - Fax:727-767-8270
Is Sole Proprietor?:No
Enumeration Date:2010-04-28
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME1279992080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases