Individual
THOMSON C PANCOAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
521 MOYE BLVD, GREENVILLE, NC 27834-2849
(252) 744-1600
(252) 744-1115
Mailing address
PO BOX 751069, CHARLOTTE, NC 28275-1069
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
043696
CT
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
043696
CT
207RP1001X
Pulmonary Disease Physician
043696
CT
207RP1001X
Pulmonary Disease Physician
Primary
2007-01829
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001436965
—
CT
Enumeration date
03/17/2006
Last updated
02/27/2024
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