Individual
ANITA J THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON-SALEM, NC 27157-0001
(336) 716-2255
Mailing address
PO BOX 344, WINSTON SALEM, NC 27102-0344
(336) 716-2255
Taxonomy
Speciality
Code
Description
License number
State
207U00000X
Nuclear Medicine Physician
Primary
2003-01299
NC
2085N0904X
Nuclear Radiology Physician
2003-01299
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023216298
—
VA
01
—
147F3
BCBS
—
01
—
202778
MEDCOST
—
05
—
3810009875
—
WV
01
—
5377406
AETNA
—
01
—
812203
PARTNERS
—
05
—
8906277
—
NC
05
—
Q01299
—
SC
Enumeration date
07/10/2007
Last updated
10/08/2010
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