Provider Demographics
NPI:1912410457
Name:TOMPKINS, CLAUDE ANTHONY (LICENSED HAIR STYLIS)
Entity type:Individual
Prefix:MR
First Name:CLAUDE
Middle Name:ANTHONY
Last Name:TOMPKINS
Suffix:
Gender:M
Credentials:LICENSED HAIR STYLIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 WOLF ST
Mailing Address - Street 2:
Mailing Address - City:FT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-3274
Mailing Address - Country:US
Mailing Address - Phone:240-413-1367
Mailing Address - Fax:
Practice Address - Street 1:4620 SAINT BARNABAS RD STE A
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-1914
Practice Address - Country:US
Practice Address - Phone:240-413-1367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-07
Last Update Date:2017-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD4469691744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1744P32000XOtherCERTIFIED HAIR LOSS SPECIALISTS