Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207L00000X | Anesthesiologist | 0101238046 | VA |
N | 208000000X | Pediatrician | 0101238046 | VA |
Y | 2080P0203X | Pediatric Critical Care Doctor | 0101238046 | VA |
NPI | 1235188020 |
---|---|
Provider Name | Thomas Joseph Cholis III |
First Address | Baltimore, MD 21279-0137 |
Second Address | Norfolk, VA 23507-1910 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 07/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
010162556 | (05) | VA |
5900782 | (05) | NC |
I31402 | (02) |