Individual
JERRY MATHEW THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
(267) 590-7000
Mailing address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501-4135
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
Primary
MT230461
PA
Other
Enumeration date
03/19/2019
Last updated
06/07/2024
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