Individual
DR. RENEE BETHEA THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1905 CARRIAGE HOUSE LN, CAMDEN, SC 29020-2752
(803) 424-2304
Mailing address
1905 CARRIAGE HOUSE LN, CAMDEN, SC 29020-2752
(803) 424-2304
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
16675
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
166750
—
SC
01
—
8256
MEDICARE GROUP
SC
01
—
DD4130
RAILROAD MEDICARE GROUP
SC
01
—
GP4159
MEDICAID GROUP
SC
01
—
P00226494
RAILROAD MEDICARE
SC
Enumeration date
01/25/2006
Last updated
04/29/2024
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