Individual
DEREK R THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
Mailing address
111 DOCTOR CIR, COLUMBIA, SC 29203-6502
(800) 491-0909
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
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