Individual
MICAH THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1752
(843) 692-1904
Mailing address
504 GLENDALYN AVE, SPARTANBURG, SC 29302-2011
(901) 826-0806
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28755
MS
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/22/2018
Last updated
05/12/2021
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