Individual
CHARLOTTE R THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2016 SUMTER ST, COLUMBIA, SC 29201-2100
(803) 744-2700
(803) 744-7979
Mailing address
2016 SUMTER ST, COLUMBIA, SC 29201-2100
(803) 744-2700
(803) 744-7979
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
22066
SC
207W00000X
Ophthalmology Physician
Primary
22066
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22066
SC MEDICAL LICENSE #
SC
01
—
8634
MEDICARE GROUP
SC
05
—
T62429
—
SC
Enumeration date
06/02/2006
Last updated
04/28/2010
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