Individual
THOMAS D. VERVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4539 HEDGEMORE DR, SUITE 100, CHARLOTTE, NC 28209-3276
(704) 331-9669
(704) 331-0736
Mailing address
PO BOX 601888, CHARLOTTE, NC 28260-1888
(704) 331-9669
(704) 331-0736
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
9300359
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396721270
—
NC
05
—
8985057
—
NC
05
—
N00359
—
SC
Enumeration date
12/21/2005
Last updated
03/20/2014
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