Provider Demographics
NPI:1174169973
Name:RADOS, THOMAS STEPHEN
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:STEPHEN
Last Name:RADOS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10200 OLD COLUMBIA RD STE C
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2364
Mailing Address - Country:US
Mailing Address - Phone:410-290-4480
Mailing Address - Fax:
Practice Address - Street 1:10200 OLD COLUMBIA RD STE C
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2364
Practice Address - Country:US
Practice Address - Phone:410-290-4480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-27
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD27783225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty