Provider Demographics
NPI:1700822848
Name:THOMAS, MICHELE D (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:D
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MICHELE
Other - Middle Name:D
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:34434 KING STREET ROW
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4787
Mailing Address - Country:US
Mailing Address - Phone:302-644-8880
Mailing Address - Fax:302-644-8882
Practice Address - Street 1:34434 KING STREET ROW
Practice Address - Street 2:SUITE 2
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4787
Practice Address - Country:US
Practice Address - Phone:302-644-8880
Practice Address - Fax:302-644-8882
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10005099208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000850001Medicaid
DEG01162Medicare ID - Type UnspecifiedMEDICARE NUMBER
DE0000850001Medicaid