Individual
DR. FRED NICHOLAS THOMAS III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2205 EXECUTIVE DR STE A, HAMPTON, VA 23666-2948
(757) 223-4992
(757) 223-5350
Mailing address
860 OMNI BLVD STE 101, NEWPORT NEWS, VA 23606-4430
(757) 232-8769
(757) 232-8875
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101238297
VA
207RA0401X
Addiction Medicine (Internal Medicine) Physician
0101238297
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518958420
—
VA
Enumeration date
10/31/2005
Last updated
01/11/2022
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