Provider Demographics
NPI:1336288166
Name:THOMAS, DAVID S (MD PA)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD PA
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 2128
Mailing Address - Street 2:14 MEDICAL PARK LOOP
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-2128
Mailing Address - Country:US
Mailing Address - Phone:828-586-7610
Mailing Address - Fax:828-586-7615
Practice Address - Street 1:14 MEDICAL PARK LOOP
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-5221
Practice Address - Country:US
Practice Address - Phone:828-586-7610
Practice Address - Fax:828-586-7615
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9600751207R00000X, 207RX0202X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
011T7OtherBCBS OF NC
NC8982549Medicaid
NC89011T7Medicaid
NC8982549Medicaid
011T7OtherBCBS OF NC
NC2336859Medicare PIN