MEDICARE: RICHARD D THOMAS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	204842	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1609386	OTHER		INDEPENDENT HEALTH
2	2048429CR	OTHER	NY	WORKERS COMPENSATION
3	000524751011	OTHER		BLUE SHIELD OF WESTERN NY
4	00025517604	OTHER		UNIVERA

General Provider Information

NPI Number	:	1184608242
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD D THOMAS MD

Provider Business Mailing Address
First Line	:	100 COLLEGE PKWY
Second Line	:	SUITE 180
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-6800
Country	:	US
Telephone Number	:	716-636-1902
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 COLLEGE PKWY
Second Line	:	SUITE 180
City	:	WILLIAMSVILLE
State	:	NY
Zip	:	14221-6800
Country	:	US
Telephone Number	:	716-636-1902
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	05/22/2008

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