Provider Demographics
NPI:1265558035
Name:THOMAS, JANICIA (MD)
Entity type:Individual
Prefix:
First Name:JANICIA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4011 COLERIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19802-1905
Mailing Address - Country:US
Mailing Address - Phone:302-368-5100
Mailing Address - Fax:302-246-2466
Practice Address - Street 1:15 OMEGA DR
Practice Address - Street 2:BLDG. K
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2057
Practice Address - Country:US
Practice Address - Phone:302-368-5100
Practice Address - Fax:302-246-2466
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0004221207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine