Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | DO23008 | OR |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | TC018927 | MI |
Y | 2081P2900X | Pain Medicine | H0074948 | MD |
NPI | 1144333972 |
---|---|
Provider Name | Thomas D Caruso |
First Address | Germantown, MD 20875-2348 |
Second Address | Frederick, MD 21702-4053 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 20/12/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F54930 | (02) | OR |