Provider Demographics
NPI:1972102994
Name:REGIONAL MEDICAL SPECIALTY ASSOCIATES
Entity Type:Organization
Organization Name:REGIONAL MEDICAL SPECIALTY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:DO, PHD
Authorized Official - Phone:610-744-2960
Mailing Address - Street 1:1088 W BALTIMORE PIKE STE 2205
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-5136
Mailing Address - Country:US
Mailing Address - Phone:610-744-2960
Mailing Address - Fax:610-744-2420
Practice Address - Street 1:1088 W BALTIMORE PIKE STE 2205
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5136
Practice Address - Country:US
Practice Address - Phone:610-744-2960
Practice Address - Fax:610-744-2420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-21
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty