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Individual

DR. ROBERT BRADLEY THOMASON III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2827 LYNDHURST AVE, SUITE 203, WINSTON SALEM, NC 27103-4145
(336) 794-8624
(336) 231-8845
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(336) 794-8624
(336) 231-8845

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
29966
NC
2086S0129X
Vascular Surgery Physician
Primary
29966
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1912967712
VA
01
29966
NC LICENSE
NC
05
8982803
NC
Enumeration date
03/24/2006
Last updated
06/15/2023
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