Individual
DIANE M THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4868 SPARKS BLVD, SUITE 102, SPARKS, NV 89436-8207
(775) 331-5023
(775) 331-5031
Mailing address
4868 SPARKS BLVD, SUITE 102, SPARKS, NV 89436-8207
(775) 331-5023
(775) 331-5031
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
9450
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002016817
—
NV
01
—
29D1015353
CLIA
NV
01
—
DQ4188
RAILROAD MEDICARE
NV
Enumeration date
01/03/2006
Last updated
07/22/2021
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