Provider Demographics
NPI:1427283886
Name:HUEBNER, THOMAS A (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:HUEBNER
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 1:6305 IVY LN
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-1465
Mailing Address - Country:US
Mailing Address - Phone:844-522-4263
Mailing Address - Fax:301-363-1099
Practice Address - Street 1:6305 IVY LN
Practice Address - Street 2:SUITE 100
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-1465
Practice Address - Country:US
Practice Address - Phone:844-522-4263
Practice Address - Fax:301-363-1099
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0075658207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology