Individual
LESLIE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
500 MEMORIAL AVE, MEDICAL BLDG SUITE 307, CUMBERLAND, MD 21502-3732
(301) 723-4965
(301) 723-4983
Mailing address
PO BOX 1571, 500 MEMORIAL AVE MEDICAL BLDG SUITE 307, CUMBERLAND, MD 21501-1571
(301) 723-4965
(301) 723-4983
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R047459
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
065761100
—
MD
Enumeration date
04/19/2007
Last updated
10/03/2017
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