Provider Demographics
NPI:1407858996
Name:HARPER, THOMAS BAILEY III (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:BAILEY
Last Name:HARPER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2090 CHARLIE HALL BLVD STE 301
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-8200
Mailing Address - Country:US
Mailing Address - Phone:843-556-9588
Mailing Address - Fax:843-556-6855
Practice Address - Street 1:2270 ASHLEY CROSSING DR
Practice Address - Street 2:SUITE 150
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5732
Practice Address - Country:US
Practice Address - Phone:843-556-9588
Practice Address - Fax:843-556-6855
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10255207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC102551Medicaid
SC102551Medicaid
SC4698Medicare PIN