MEDICARE: DR. DAVID W THOMAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	12093	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	001722083	OTHER	WV	MS BCBS
2	4242420	OTHER	WV	AETNA
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255334405
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID W THOMAS MD

Provider Business Mailing Address
First Line	:	301-6 GREAT TEAYS BLVD
Second Line	:
City	:	SCOTT DEPOT
State	:	WV
Zip	:	25560
Country	:	US
Telephone Number	:	304-757-6999
Fax Number	:	304-757-3252

Provider Business Practice Location Address
First Line	:	830 PENNSYLVANIA AVE
Second Line	:	STE 402
City	:	CHARLESTON
State	:	WV
Zip	:	25302-3390
Country	:	US
Telephone Number	:	304-343-5736
Fax Number	:	304-343-5271

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/11/2011

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Directions to “ DR. DAVID W THOMAS MD” Practice Location

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