Provider Demographics
NPI:1710198577
Name:THOMAS, SHERINE J (MD)
Entity Type:Individual
Prefix:DR
First Name:SHERINE
Middle Name:J
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1835 SAVOY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1072
Mailing Address - Country:US
Mailing Address - Phone:770-760-9949
Mailing Address - Fax:770-760-9951
Practice Address - Street 1:1501 MILSTEAD RD NE
Practice Address - Street 2:SUITE 110
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3838
Practice Address - Country:US
Practice Address - Phone:770-760-9949
Practice Address - Fax:770-760-9951
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2020-08-25
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Provider Licenses
StateLicense IDTaxonomies
GA064734207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA438384066DMedicaid
GA202I832080Medicare PIN
GAP00881725OtherRR MEDICARE
GA438384066CMedicaid
GA438384066BMedicaid