Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 1752 | NC |
NPI | 1447219050 |
---|---|
Provider Name | Dr. David P. Thomas |
First Address | Charlotte, NC 28217-1615 |
Second Address | Charlotte, NC 28217-1615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2006 |
Last Update Date | 26/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2446657 | MEDICARE INDIVIDUAL NUMBE (01) | NC |
U02211 | (02) | NC |