Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | 5647 | SC |
NPI | 1669469060 |
---|---|
Provider Name | Dr. Raymond L Thomas |
First Address | Florence, SC 29501-4090 |
Second Address | Florence, SC 29506-2617 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2005 |
Last Update Date | 22/11/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
056478 | (05) | SC |
06818 | BCBS OF NC (01) | NC |
154758900 | US DEPT OF LABOR (01) | SC |
300020866 | RAILROAD MEDICARE (01) | SC |
31717 | MEDCOST (01) | SC |
570525838 | STANDARD TAX ID (01) | SC |
8906818 | NC MEDICAID (01) | NC |
C86748 | (02) | SC |