MEDICARE: MR. CLAUDE ANTHONY TOMPKINS LICENSED HAIR STYLIS

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	1744P3200X	Prosthetics Case Management	446969	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1744P32000X	OTHER	MD	CERTIFIED HAIR LOSS SPECIALISTS

General Provider Information

NPI Number	:	1912410457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CLAUDE ANTHONY TOMPKINS LICENSED HAIR STYLIS

Provider Business Mailing Address
First Line	:	2004 WOLF ST
Second Line	:
City	:	FT WASHINGTON
State	:	MD
Zip	:	20744-3274
Country	:	US
Telephone Number	:	240-413-1367
Fax Number	:

Provider Business Practice Location Address
First Line	:	4620 SAINT BARNABAS RD STE A
Second Line	:
City	:	TEMPLE HILLS
State	:	MD
Zip	:	20748-1914
Country	:	US
Telephone Number	:	240-413-1367
Fax Number	:

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

Provider Enumeration Date	:	11/07/2017
Last Update Date	:	11/07/2017

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