Provider Demographics
NPI:1386904290
Name:THODE, JOAN BRUMBAUGH (MD)
Entity type:Individual
Prefix:DR
First Name:JOAN
Middle Name:BRUMBAUGH
Last Name:THODE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JOAN
Other - Middle Name:KRISTIN
Other - Last Name:BRUMBAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:540 N DUKE ST FL 3
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2374
Mailing Address - Country:US
Mailing Address - Phone:717-544-4950
Mailing Address - Fax:717-544-5964
Practice Address - Street 1:540 N DUKE ST FL 3
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2374
Practice Address - Country:US
Practice Address - Phone:717-544-4950
Practice Address - Fax:717-544-5964
Is Sole Proprietor?:No
Enumeration Date:2012-05-24
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD453839208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics