Healthcare Provider Details

I. General information

NPI: 1871792341
Provider Name (Legal Business Name): ANDREW R. THOMAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2007
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 1ST AVE
VIENNA WV
26105-2710
US

IV. Provider business mailing address

200 LOTHROP ST DEPT OF RADIOLOG PRESBY SOUTH TOWER, 8TH FLOOR, 8 NORTH
PITTSBURGH PA
15213
US

V. Phone/Fax

Practice location:
  • Phone: 248-225-0048
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085D0003X
TaxonomyDiagnostic Neuroimaging (Radiology) Physician
License NumberMT201961
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD445816
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301090575
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: