Healthcare Provider Details

I. General information

NPI: 1326426925
Provider Name (Legal Business Name): ANDREW PAUL THOME MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/14/2015
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 POND PARK RD STE 102
HINGHAM MA
02043-4354
US

IV. Provider business mailing address

71 BORDER RD STE 300
WALTHAM MA
02451-1044
US

V. Phone/Fax

Practice location:
  • Phone: 781-337-5555
  • Fax: 781-335-6047
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number1023706
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number2022010975
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: