NPI 1295808848 · live from the CMS NPI Registry
Thomas George Bastholm, O.D.
Optometrist in Lewes, DE. National Provider Identifier 1295808848, active.
NPI record
| NPI | 1295808848 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 1540 Savannah Rd, Lewes, DE 19958 |
| Practice phone | 302-645-2020 |
| Enumerated | November 15, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | DEI30001133 (DE) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.