Provider Demographics
NPI:1689734311
Name:MARBURY, THOMAS CRAWFORD (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CRAWFORD
Last Name:MARBURY
Suffix:
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 1:5055 S. ORANGE AVE
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32809-3017
Mailing Address - Country:US
Mailing Address - Phone:407-472-0227
Mailing Address - Fax:407-240-9846
Practice Address - Street 1:5055 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32809-3017
Practice Address - Country:US
Practice Address - Phone:407-472-0227
Practice Address - Fax:407-240-9846
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME27544207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLD57796Medicare UPIN