Healthcare Provider Details

I. General information

NPI: 1942249487
Provider Name (Legal Business Name): BRIDGET A THOMAS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901C PEACHTREE DUNWOODY RD NE SUITE 350
ATLANTA GA
30328-5382
US

IV. Provider business mailing address

4093 DIAMOND RUBY SUNNY ISLE ANNEX, SUITE 7, BOX PMB 401
CHRISTIANSTED VI
00820-4424
US

V. Phone/Fax

Practice location:
  • Phone: 678-397-0060
  • Fax: 678-397-0065
Mailing address:
  • Phone: 340-642-9135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number047852
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: