Individual
GEORGE THEKKANATTU THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
BUILDING 140 CAMPUS DRIVE, UNIVERSITY HEALTH CENTER, COLLEGE PARK, MD 20742
(301) 314-8095
Mailing address
8163 MANDAN TER, GREENBELT, MD 20770-2643
(301) 247-0844
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
C0004724
MD
Other
Enumeration date
09/19/2012
Last updated
02/23/2016
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