Healthcare Provider Details

I. General information

NPI: 1215013255
Provider Name (Legal Business Name): JOAN REDFEARN-THOMPSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6196 OXON HILL RD. SUITE 610
OXON HILL MD
20745-3112
US

IV. Provider business mailing address

6196 OXON HILL RD. SUITE 610
OXON HILL MD
20745-3112
US

V. Phone/Fax

Practice location:
  • Phone: 301-839-5804
  • Fax: 301-839-6882
Mailing address:
  • Phone: 301-839-5804
  • Fax: 301-839-6882

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberD0035456
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: