Provider Demographics
NPI:1356397251
Name:THOMAS, LEA ANDERSON (MD)
Entity type:Individual
Prefix:DR
First Name:LEA
Middle Name:ANDERSON
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:11783 ROCK LANDING DR
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23606-4431
Mailing Address - Country:US
Mailing Address - Phone:757-668-6320
Mailing Address - Fax:757-668-6315
Practice Address - Street 1:11783 ROCK LANDING DR
Practice Address - Street 2:SUITE 202
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23606-4431
Practice Address - Country:US
Practice Address - Phone:757-668-6320
Practice Address - Fax:757-668-6315
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2013-09-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101231367208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA10002260OtherOPTIMA
VA188471OtherANTHEM
VA4136395OtherUNITED HEALTHCARE
VA541778786OtherTAX ID #
VA8136395OtherMAMSI
VA010240531Medicaid
VA7755119OtherAETNA
VA7758175OtherCIGNA
VAH05610Medicare UPIN