Provider Demographics
NPI:1245245802
Name:LE, THOMAS T (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:T
Last Name:LE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4785 DORSEY HALL DR STE 111
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7862
Mailing Address - Country:US
Mailing Address - Phone:877-917-3223
Mailing Address - Fax:443-219-0758
Practice Address - Street 1:4785 DORSEY HALL DR STE 111
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7862
Practice Address - Country:US
Practice Address - Phone:877-917-3223
Practice Address - Fax:443-219-0758
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD61873207Y00000X, 207YS0123X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD252644OtherKAISER
MD3125711OtherMDIPA
MD64272901OtherBLUE SHIELD
MD0006OtherCAREFIRST REGIONAL
MD1001582OtherUNITED HLTHCARE
MD2313163OtherUNITED HLTHCARE NATIONAL
MD406120900Medicaid
MD94501OtherGEISINGER
MD64272901OtherBLUE SHIELD