Individual
DEREK R THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19357
SC
207RC0000X
Cardiovascular Disease Physician
19357
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
193579
—
SC
01
—
571053169
TAX ID
—
Enumeration date
08/31/2006
Last updated
01/18/2024
Update your record
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