Provider Demographics
NPI:1003809807
Name:THOMAS, PAUL D (DO)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:250 FAME AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HANOVER
Mailing Address - State:PA
Mailing Address - Zip Code:17331-1587
Mailing Address - Country:US
Mailing Address - Phone:717-633-9086
Mailing Address - Fax:717-633-9379
Practice Address - Street 1:250 FAME AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:HANOVER
Practice Address - State:PA
Practice Address - Zip Code:17331-1587
Practice Address - Country:US
Practice Address - Phone:717-633-9086
Practice Address - Fax:717-633-9379
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAOS-006926-L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA721372R4QMedicare PIN
PAF26618Medicare UPIN
PA073687Medicare PIN