Provider Demographics
NPI:1063664894
Name:THOMAS, SCOTT E (MD, MBA)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:E
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 CHAPMAN LOOP
Mailing Address - Street 2:
Mailing Address - City:PAWLEYS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29585-7630
Mailing Address - Country:US
Mailing Address - Phone:303-579-8759
Mailing Address - Fax:
Practice Address - Street 1:313 CHAPMAN LOOP
Practice Address - Street 2:
Practice Address - City:PAWLEYS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29585-7630
Practice Address - Country:US
Practice Address - Phone:303-579-8759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-10
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME113353207L00000X
NC2016-00279207L00000X
SC35592207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology