Individual
DR. MATHEW KADALIKATTIL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1138 CHERAW ST, BENNETTSVILLE, SC 29512-2466
(843) 454-8580
Mailing address
1162 ADAMSVILLE RD N, MC COLL, SC 29570-5001
(716) 239-6879
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
31752
SC
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
31752
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
317525
—
RI
Enumeration date
01/15/2009
Last updated
09/01/2015
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