Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 0101037103 | VA |
NPI | 1003885898 |
---|---|
Provider Name | Dr. Thomas P Officer |
First Address | Fredericksburg, VA 22401-3357 |
Second Address | Fredericksburg, VA 22401-3357 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2006 |
Last Update Date | 13/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00414803 | AETNA (01) | VA |
006061176 | (05) | VA |
094198 | ANTHEM BC BS (01) | VA |
1100499769 | RAILROAD (01) | VA |
D98270 | (02) | VA |