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Individual

CHRISTOPHER STEPHEN THOM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, PHD

Contact information

Practice address
3401 CIVIC CENTER BLVD, 9NW, ROOM 55, PHILADELPHIA, PA 19104-4319
(215) 590-1220
Mailing address
3401 CIVIC CENTER BLVD, 9NW, ROOM 55, PHILADELPHIA, PA 19104-4319

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
1013397025
PA
208000000X
Pediatrics Physician
MT208697
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
MT208697
PA
Enumeration date
06/04/2015
Last updated
06/07/2017
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