Individual
SAMUEL THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
339 SQUIRE RD STE 130-134, REVERE, MA 02151-4396
(781) 629-4897
Mailing address
339 SQUIRE RD STE 130-134, REVERE, MA 02151-4396
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA100925
MA
Other
Enumeration date
04/30/2024
Last updated
10/10/2024
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