Provider Demographics
NPI:1043218316
Name:THOMAS, GARY W (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:W
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 HOSPITAL CENTER CMNS
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2837
Mailing Address - Country:US
Mailing Address - Phone:843-689-2895
Mailing Address - Fax:843-689-9270
Practice Address - Street 1:45 HOSPITAL CENTER CMNS
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2837
Practice Address - Country:US
Practice Address - Phone:843-699-2895
Practice Address - Fax:843-689-9270
Is Sole Proprietor?:No
Enumeration Date:2005-07-12
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA33470207RH0003X
SC14194207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP00056823OtherRAILROAD MEDICARE
SCG07329Medicaid
SCG07329Medicaid
SCP00056823OtherRAILROAD MEDICARE