Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 000039490 | NC |
N | 207V00000X | Obstetrician & Gynecologist | 11316 | SC |
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 11316 | SC |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 39490 | NC |
NPI | 1134137912 |
---|---|
Provider Name | Dr. Thomas M Stubbs |
First Address | Columbia, SC 29203-6839 |
Second Address | Columbia, SC 29203-6839 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/08/2006 |
Last Update Date | 01/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113166 | (05) | SC |
1134137912 | (05) | NC |
7980695 | (05) | NC |
80695 | BCBS NC (01) | NC |
C60344 | (02) | NC |