Provider Demographics
NPI:1144333972
Name:CARUSO, THOMAS D (DO)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:D
Last Name:CARUSO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2348
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20875-2348
Mailing Address - Country:US
Mailing Address - Phone:240-629-3982
Mailing Address - Fax:
Practice Address - Street 1:1050 KEY PKWY
Practice Address - Street 2:SUITE 103
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4053
Practice Address - Country:US
Practice Address - Phone:240-629-3939
Practice Address - Fax:240-629-3932
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO23008204C00000X
MITC018927208100000X
MDH00749482081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA014644C19Medicare PIN
VAP00427598Medicare PIN
ORF54930Medicare UPIN