Individual
THOMAS JOHN ANTALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
511 RIDGE RD, ROXBORO, NC 27573-4627
(336) 597-5462
(336) 597-9428
Mailing address
PO BOX 3193, DURHAM, NC 27715-3193
(919) 544-6318
(919) 544-6336
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
37999
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8912194
—
NC
Enumeration date
03/23/2006
Last updated
11/11/2009
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