Doctor Name: | SUSAN L THOMAS |
NPI Number: | 1093065914 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 18009 |
Business Practice Address: | 526 North St Bamberg, SC - 290031319 |
Business Phone Number: | 8032452433 |
Business Fax Number: | 8032456274 |
Mailing Address: | 526 North St, BAMBERG |
State: | SC |
Postal Code: | 290031319 |
Phone Number: | 8032452433 |
Fax Number: | 8032456274 |
NPI Enumeration Date: | 09/18/2012 |
NPI Last Update Date: | 03/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 18009 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |