Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 2017-00204 | NC |
NPI | 1003235292 |
---|---|
Provider Name | Dr. Scott Warren Thomas |
First Address | Charlotte, NC 28260-0447 |
Second Address | Matthews, NC 28105-5403 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 27/10/2020 |