Provider Demographics
NPI:1538797113
Name:THOMAS, ANDREW JOHN (MD)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOHN
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:VAN THOMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2300 WALL ST STE D
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:45212-2742
Mailing Address - Country:US
Mailing Address - Phone:513-517-3299
Mailing Address - Fax:513-517-7311
Practice Address - Street 1:2300 WALL ST STE D
Practice Address - Street 2:
Practice Address - City:NORWOOD
Practice Address - State:OH
Practice Address - Zip Code:45212-2742
Practice Address - Country:US
Practice Address - Phone:513-517-3299
Practice Address - Fax:513-517-7311
Is Sole Proprietor?:No
Enumeration Date:2020-03-30
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1514242084P0804X
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry