Organization
THOMAS L EDMONDSON MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS L EDMONDSON III M.D. (PRESIDENT)
(410) 961-5500
Entity
Organization
Contact information
Practice address
1311 PARK AVE, BALTIMORE, MD 21217-4104
(410) 961-5500
(800) 600-4124
Mailing address
1311 PARK AVE, BALTIMORE, MD 21217-4104
(410) 961-5500
(800) 600-4124
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D45766
MD
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
D45766
MD
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
D45766
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1659340230
NPI
MD
Enumeration date
12/29/2011
Last updated
12/29/2011
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