Individual
DR. MICHELLE DENISE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12172 CENTRAL AVE, #100, MITCHELLVILLE, MD 20721-1900
(307) 390-5704
(301) 464-7921
Mailing address
PO BOX 15609, WASHINGTON, DC 20003-0609
(301) 390-5704
(301) 464-7921
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
D41401
MD
2086S0102X
Surgical Critical Care Physician
073406
GA
208D00000X
General Practice Physician
0101056850
VA
208D00000X
General Practice Physician
D41401
MD
208D00000X
General Practice Physician
MD19906
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003
CAREFIRST
—
01
—
104768800
DEPT OF LABOR/FEDERAL WORKMAN'S COMP
—
01
—
3112384
AETNA HMO
—
05
—
348211100
—
MD
01
—
35198002
CAREFIRST
—
05
—
384211100
—
MD
01
—
4348841
AETNA PPO
—
Enumeration date
07/19/2005
Last updated
03/01/2021
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