Provider Demographics
NPI:1063738987
Name:THODE, ADAM RYAN (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:RYAN
Last Name:THODE
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 1:2115 NOLL DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-7600
Mailing Address - Country:US
Mailing Address - Phone:717-393-7980
Mailing Address - Fax:717-509-5079
Practice Address - Street 1:2115 NOLL DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-7600
Practice Address - Country:US
Practice Address - Phone:717-393-7980
Practice Address - Fax:717-509-5079
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD453738207W00000X
NY264875207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology