Provider Demographics
NPI:1215984406
Name:THOMAS, CHRISTINE ANDERSON (MD)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:ANDERSON
Last Name:THOMAS
Suffix:
Gender:F
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:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:EMMITSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21727-0190
Mailing Address - Country:US
Mailing Address - Phone:301-447-3369
Mailing Address - Fax:301-447-2485
Practice Address - Street 1:302 W MAIN ST
Practice Address - Street 2:
Practice Address - City:EMMITSBURG
Practice Address - State:MD
Practice Address - Zip Code:21727-9192
Practice Address - Country:US
Practice Address - Phone:301-447-3369
Practice Address - Fax:301-447-2485
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD39937208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD152471200Medicaid
MD2517CAMedicare ID - Type Unspecified
MD152471200Medicaid