MEDICARE: THOMAS C HAVELL M.D.

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	207RH0000X	Hematology (Internal Medicine) Physician	DC6104	DC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110239370	OTHER	DC	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1396779310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS C HAVELL M.D.

Provider Business Mailing Address
First Line	:	3100 WYMAN PARK DR
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21211-2803
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5215 LOUGHBORO RD NW
Second Line	:	SUITE 300
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2618
Country	:	US
Telephone Number	:	202-243-4480
Fax Number	:

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	05/09/2013

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Directions to “ THOMAS C HAVELL M.D.” Practice Location

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