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General NPI Number Information
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NPI Number | 1457457939
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Entity Type | Individual
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Provider Name | JEFFREY THOMPSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 500 UPPER CHESAPEAKE DR
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City | BEL AIR
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State | MD
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Zip | 21014-4324
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Country | US
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Telephone | 443-643-1000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 827435
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City | PHILADELPHIA
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State | PA
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Zip | 19182-7435
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number | D0053568
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License Number State | MD
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