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General NPI Number Information
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NPI Number | 1861812174
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Entity Type | Individual
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Provider Name | KELSEY RENEE THRUSH D.O.
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Gender | Female
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Dates
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Enumeration Date | 04/25/2014
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 101 E CHARLES ST STE 104
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City | LA PLATA
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State | MD
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Zip | 20646-4901
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Country | US
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Telephone | 301-609-4800
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Fax |
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Provider Business Mailing Address
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Address Line | 3700 MASSACHUSETTS AVE NW APT 514
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City | WASHINGTON
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State | DC
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Zip | 20016-5808
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Country | US
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Telephone | 717-372-9845
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | DO034719
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | H84944
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License Number State | MD
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