Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 2003-01299 | NC |
NPI | 1023216298 |
---|---|
Provider Name | Anita J Thomas |
First Address | Winston Salem, NC 27102-0344 |
Second Address | Winston-Salem, NC 27157-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2007 |
Last Update Date | 08/10/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1023216298 | (05) | VA |
147F3 | BCBS (01) | |
202778 | MEDCOST (01) | |
3810009875 | (05) | WV |
5377406 | AETNA (01) | |
812203 | PARTNERS (01) | |
8906277 | (05) | NC |
A99969 | (02) | |
Q01299 | (05) | SC |