Provider Demographics
NPI:1457694010
Name:ADRIAN, THOMAS LEENEY (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:LEENEY
Last Name:ADRIAN
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 1:3301 NEW MEXICO AVE NW STE 240
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-3610
Mailing Address - Country:US
Mailing Address - Phone:202-966-8814
Mailing Address - Fax:202-966-7001
Practice Address - Street 1:3301 NEW MEXICO AVE NW STE 240
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-3610
Practice Address - Country:US
Practice Address - Phone:202-966-8814
Practice Address - Fax:202-966-7001
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
DCMD043088207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AT2438946-I63OtherDEA#