Individual
JOSEPH DEER THOMAS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
606 R PINCKNEY STREET, MC CLELLANVILLE, SC 29458
(843) 398-8838
(843) 398-8839
Mailing address
PO BOX 636, 606 R PINCKNEY ST., MC CLELLANVILLE, SC 29458-0636
(843) 398-8838
(843) 398-8839
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
09827
SC
207Q00000X
Family Medicine Physician
Primary
09827
SC
2083X0100X
Occupational Medicine Physician
09827
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080180703
RR MEDICARE
SC
05
—
098272
—
SC
01
—
P00313042
RR MEDICARE
SC
Enumeration date
06/06/2006
Last updated
05/06/2013
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