Individual
CANDICE A THORNTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31842
SC
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
31842
SC
208000000X
Pediatrics Physician
31842
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
318427
—
SC
Enumeration date
06/18/2009
Last updated
06/08/2021
Update your record
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