Individual
THOMAS H DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1780 MEDICAL PARK DR, ROCK HILL, SC 29732-1194
(803) 327-1116
(803) 327-6872
Mailing address
9735 KINCEY AVE, SUITE 201, HUNTERSVILLE, NC 28078-9118
(704) 414-2870
(704) 414-2860
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
0101045853
VA
208800000X
Urology Physician
Primary
21281
SC
208800000X
Urology Physician
99-00476
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007034011
AETNA
SC
01
—
136HX
BCBS OF NC
NC
01
—
1905793
UNITED HEALTHCARE
SC
05
—
212816
—
SC
01
—
279873
MAMSI
SC
01
—
867215
GREAT WEST
SC
05
—
8912374
—
NC
01
—
90023
MEDCOST
SC
Enumeration date
11/17/2006
Last updated
05/26/2021
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