Healthcare Provider Details

I. General information

NPI: 1285847855
Provider Name (Legal Business Name): MARIA THOMAS-JOHN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 11/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 S MAIN ST SUITE 3
DAYTON OH
45409-2698
US

IV. Provider business mailing address

1520 S MAIN ST SUITE 3
DAYTON OH
45409-2698
US

V. Phone/Fax

Practice location:
  • Phone: 937-208-7275
  • Fax: 937-208-7282
Mailing address:
  • Phone: 937-208-7275
  • Fax: 937-208-7282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number35.087224
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: