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General NPI Number Information
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NPI Number | 1548157944
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Entity Type | Individual
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Provider Name | HALLIE THOMAS PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 09/04/2025
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Provider Practice Location Address
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Address Line | 7211 BANK CT
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City | FREDERICK
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State | MD
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Zip | 21703-8483
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Country | US
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Telephone | 301-418-6611
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FREDERICK HEALTH WAY
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City | FREDERICK
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State | MD
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Zip | 21701-9435
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Country | US
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Telephone | 240-439-8910
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Fax | 240-566-7754
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0009963
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License Number State | MD
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