Healthcare Provider Details

I. General information

NPI: 1235076670
Provider Name (Legal Business Name): MR. EDWARD J THOMAS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2528 MOUNTAIN RD
PASADENA MD
21122-7203
US

IV. Provider business mailing address

1022 HOLLINS ST
BALTIMORE MD
21223-2537
US

V. Phone/Fax

Practice location:
  • Phone: 443-548-3733
  • Fax:
Mailing address:
  • Phone: 302-359-4458
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number34337
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: