Healthcare Provider Details

I. General information

NPI: 1487651584
Provider Name (Legal Business Name): CHRISTIAN ANTON THOMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 04/28/2025
Certification Date: 04/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 ROCK ROW STE 120
WESTBROOK ME
04092-4877
US

IV. Provider business mailing address

P.O. BOX 911
BRATTLEBORO VT
05302
US

V. Phone/Fax

Practice location:
  • Phone: 207-303-3300
  • Fax: 207-250-2139
Mailing address:
  • Phone: 207-303-3200
  • Fax: 207-250-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number15893
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD19427
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: