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Individual

MARVA THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1330 BOILING SPRINGS RD, SUITE 2500, SPARTANBURG, SC 29303-4201
(864) 585-5433
(864) 591-4053
Mailing address
PO BOX 2288, SPARTANBURG, SC 29304-2288
(864) 585-5433
(864) 591-4053

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
19219
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP3064
SC
01
P01617602
RAILROAD MEDICARE
SC
01
P0L505947
RAILROAD MEDICARE
SC
Enumeration date
12/23/2014
Last updated
04/18/2016
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