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Individual
THOMAS DALE TATE
Active
Individual
THOMAS DALE TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29804
NC
208D00000X
General Practice Physician
29804
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-28815
UNITED HEALTHCARE
NC
01
—
080125891
RAILROAD MEDICARE
NC
01
—
81658
BCBS
NC
01
—
B4136
MEDCOST
NC
Enumeration date
06/15/2005
Last updated
11/16/2009
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