Provider Demographics
NPI:1467499608
Name:D'ALESSIO, THOMAS LOUIS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:LOUIS
Last Name:D'ALESSIO
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 63112
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28263-3112
Mailing Address - Country:US
Mailing Address - Phone:336-274-9617
Mailing Address - Fax:336-482-2177
Practice Address - Street 1:1331 NORTH ELM STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-6304
Practice Address - Country:US
Practice Address - Phone:336-274-9617
Practice Address - Fax:336-482-2177
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC99013942085R0202X
NC99-013942085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1280YOtherBCBS OF NC
NCP00286541OtherRAILROAD MEDICARE
NC184442OtherMEDCOST
NC1602530OtherUNITED HEALTHCARE
NC41929OtherPARTNERS
NC891280YMedicaid
NC91037BMedicare UPIN
NC891280YMedicaid