Healthcare Provider Details

I. General information

NPI: 1104870146
Provider Name (Legal Business Name): DAVID A THOMAS DO, PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1788 WILMINGTON PIKE SUITE 100
GLEN MILLS PA
19342
US

IV. Provider business mailing address

1788 WILMINGTON PIKE SUITE 100
GLEN MILLS PA
19342
US

V. Phone/Fax

Practice location:
  • Phone: 610-744-2960
  • Fax: 610-744-2420
Mailing address:
  • Phone: 610-744-2960
  • Fax: 610-744-2420

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberOS004234L
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPS004113L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: