Provider Demographics
NPI:1760942874
Name:DI VITANTONIO, THOMAS ALBERT (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ALBERT
Last Name:DI VITANTONIO
Suffix:
Gender:M
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:JOHNS HOPKINS PULMONARY AND CRITICAL CARE MEDICINE
Mailing Address - Street 2:1830 E. MONUMENT STREET, 5TH FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:JOHNS HOPKINS ASTHMA AND ALLERGY CENTER
Practice Address - Street 2:5501 HOPKINS BAYVIEW CIRCLE, 2ND FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224
Practice Address - Country:US
Practice Address - Phone:410-550-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-23
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY314914207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine