Provider Demographics
NPI:1831147180
Name:THOMAS, JAMES W (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:THOMAS
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 1:980 US HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:SOUTH AMBOY
Mailing Address - State:NJ
Mailing Address - Zip Code:08879-3320
Mailing Address - Country:US
Mailing Address - Phone:732-553-9729
Mailing Address - Fax:732-553-9730
Practice Address - Street 1:2412-14 WEST PASSYUNK AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145
Practice Address - Country:US
Practice Address - Phone:215-462-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4175762085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Not Answered2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1316606OtherHIGHMARK BLUESHIELD
PA2009692000OtherAMERIHEALTH/INTERCOUNTY
PA30026851OtherKEYSTONE MERCY
PA2009692000OtherIBC - PC/KHPE
PA4643805OtherAETNA PPO
PA1044358OtherCIGNA HMO/PPO
PA0018564430022Medicaid
PAH23958Medicare UPIN
PA0018564430022Medicaid