Individual
DR. THERESA THOMAS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1210 CHUCK DAWLEY BLVD, MOUNT PLEASANT, SC 29464-4186
(843) 971-1955
(843) 974-8044
Mailing address
1210 CHUCK DAWLEY BLVD, MOUNT PLEASANT, SC 29464-4186
(843) 971-1955
(843) 974-8044
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
17520
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
175205
—
SC
Enumeration date
04/19/2006
Last updated
07/08/2007
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