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THOMAS SANDERSON GAVIGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1350 S KINGS DR, CHARLOTTE, NC 28207-2134
(704) 446-1255
Mailing address
PO BOX 19305, CHARLOTTE, NC 28219-9305

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2020-02743
NC
2086S0102X
Surgical Critical Care Physician
Primary
2020-02743
NC

Other

Enumeration date
05/12/2014
Last updated
05/04/2023
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