Provider Demographics
NPI:1447244181
Name:EHRLICH, THOMAS PAUL (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:PAUL
Last Name:EHRLICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3650 JOSEPH SIEWICK DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-1710
Mailing Address - Country:US
Mailing Address - Phone:703-391-2020
Mailing Address - Fax:703-391-1211
Practice Address - Street 1:3650 JOSEPH SIEWICK DR
Practice Address - Street 2:SUITE 400
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1710
Practice Address - Country:US
Practice Address - Phone:703-391-2020
Practice Address - Fax:703-391-1211
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101046955207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA05622531Medicaid
VA080182894OtherRR MEDICARE
VA00A434F32Medicare ID - Type Unspecified
VA080182894OtherRR MEDICARE