Provider Demographics
NPI:1225134075
Name:THOMAS, MELANIE B (MD)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:B
Last Name:THOMAS
Suffix:
Gender:F
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:PO BOX 743070
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3070
Mailing Address - Country:US
Mailing Address - Phone:864-560-4304
Mailing Address - Fax:864-560-4413
Practice Address - Street 1:2759 S HIGHWAY 14
Practice Address - Street 2:SUITE A
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-4926
Practice Address - Country:US
Practice Address - Phone:864-849-9701
Practice Address - Fax:864-849-9710
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL3161207RX0202X
SC31265207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP01533239OtherRAILROAD MEDICARE
TX152587501Medicaid
SC312655Medicaid
SCP01533239OtherRAILROAD MEDICARE
SC312655Medicaid