Provider Demographics
NPI:1942213285
Name:THOMPSON, STERLING WASHINGTON (MD)
Entity Type:Individual
Prefix:DR
First Name:STERLING
Middle Name:WASHINGTON
Last Name:THOMPSON
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 1:2351 STANLEY AVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45404-1201
Mailing Address - Country:US
Mailing Address - Phone:937-228-0990
Mailing Address - Fax:
Practice Address - Street 1:2351 STANLEY AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45404-1201
Practice Address - Country:US
Practice Address - Phone:937-228-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301088869207Q00000X
OH35.127498207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0152765Medicaid