Provider Demographics
NPI:1689606923
Name:STILES, THOMAS MARVIN (MD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MARVIN
Last Name:STILES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:12720 MCMANUS BLVD
Mailing Address - Street 2:SUITE 311
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-4414
Mailing Address - Country:US
Mailing Address - Phone:757-872-0548
Mailing Address - Fax:757-872-0551
Practice Address - Street 1:12720 MCMANUS BLVD
Practice Address - Street 2:SUITE 311
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4414
Practice Address - Country:US
Practice Address - Phone:757-872-0548
Practice Address - Fax:757-872-0551
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2010-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101016325207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006400540Medicaid
B06588Medicare UPIN
00Y181D01Medicare PIN