Individual
MATTIE THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-2300
Mailing address
169 ASHLEY AVE, CHARLESTON, SC 29425-8905
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
LL97108
SC
Other
Enumeration date
06/13/2026
Last updated
06/13/2026
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