Individual
STEPHEN MARK THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1204 PALMETTO PENINSULA DR, MOUNT PLEASANT, SC 29464-7452
(843) 901-2386
(843) 936-1626
Mailing address
1204 PALMETTO PENINSULA DR, MOUNT PLEASANT, SC 29464-7452
(843) 901-2386
(843) 936-1626
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28138
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281386
—
SC
01
—
GP1551
MEDICAID GROUP
SC
01
—
P00630905
RR MEDICARE
SC
Enumeration date
10/12/2006
Last updated
04/25/2017
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