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Individual

KEVIN THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
560 RIVERSIDE DR, SUITE A-101, SALISBURY, MD 21801-4700
(410) 749-0121
(410) 749-6807
Mailing address
560 RIVERSIDE DR, SUITE A-101, SALISBURY, MD 21801-4700
(410) 749-0121
(410) 749-6807

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
01513
MD
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
SC005904
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
243715YHZX
MEDICARE UNSPECIFIED
MD
01
PENDING
CAREFIRST
MD
05
PENDING
MD
Enumeration date
06/13/2007
Last updated
09/12/2012
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