Provider Demographics
NPI:1124210133
Name:BRESLEY, THOMAS DEAN (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:DEAN
Last Name:BRESLEY
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 1:2149 VALLEYGATE DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-3672
Mailing Address - Country:US
Mailing Address - Phone:910-687-4888
Mailing Address - Fax:
Practice Address - Street 1:2149 VALLEYGATE DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28304
Practice Address - Country:US
Practice Address - Phone:910-687-4888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-00820207Q00000X
DCMD18536207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine