Basic Information
| Provider Information | |||||||||
| NPI: | 1942249487 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | THOMAS | ||||||||
| FirstName: | BRIDGET | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4093 DIAMOND RUBY | ||||||||
| Address2: | SUNNY ISLE ANNEX, SUITE 7, BOX PMB 401 | ||||||||
| City: | CHRISTIANSTED | ||||||||
| State: | VI | ||||||||
| PostalCode: | 008204424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3406429135 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5901C PEACHTREE DUNWOODY RD NE | ||||||||
| Address2: | SUITE 350 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303285382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6783970060 | ||||||||
| FaxNumber: | 6783970065 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 047852 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.