Provider Demographics
NPI:1821600503
Name:THOMAS, SANDRA D
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:D
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:322 BALDWIN RD APT 307
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-1283
Mailing Address - Country:US
Mailing Address - Phone:301-256-1586
Mailing Address - Fax:
Practice Address - Street 1:3700 9TH ST SE APT 125
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4009
Practice Address - Country:US
Practice Address - Phone:202-215-6291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-23
Last Update Date:2020-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant