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Individual
DR. FREDERICK W. THOM
Active
Individual
DR. FREDERICK W. THOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G61780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0217529
WASHINGTON STATE DOL PROV
—
01
—
235229
BLUE CROSS WORKERS COMP P
—
01
—
240629
BLUE CROSS WORKERS COMP K
—
01
—
240630
BLUE CROSS WORKERS COMP S
—
01
—
5255526
PPNI
—
01
—
DF2146
RAILROAD MEDICARE GROUP
—
01
—
G61780
LICENSE
—
01
—
P00347364
RAILROAD MEDICARE PIN
—
Enumeration date
03/07/2006
Last updated
07/11/2008
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