Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 0116021437 | VA |
Y | 207QS0010X | Family Doctor - Sports Medicine | 0101247923 | VA |
NPI | 1013144419 |
---|---|
Provider Name | Dr. Eric M Thomson |
First Address | Fairfax, VA 22033-3315 |
Second Address | Vienna, VA 22180 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2009 |
Last Update Date | 19/10/2020 |