Individual
DR. KOITHARA VARKEY THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
EASTERN NEPHROLOGY ASSOCIATES, 277 MEMORIAL DRIVE, JACKSONVILLE, NC 28546-6333
(910) 346-2263
(910) 353-0549
Mailing address
277 MEMORIAL DRIVE, JACKSONVILLE, NC 28546-6333
(910) 343-9800
(910) 343-8650
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
200300295
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134WE
BC/BS-NC INDIVIDUAL #
NC
01
—
1587680
UNITED HEALTH CARE
NC
05
—
89134WE
—
NC
Enumeration date
06/12/2006
Last updated
10/01/2020
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