Provider Demographics
NPI:1508839424
Name:D'ORAZIO, THOMAS J (MD, PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:J
Last Name:D'ORAZIO
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8210 DEVON CT # B
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29572-4178
Mailing Address - Country:US
Mailing Address - Phone:843-839-5328
Mailing Address - Fax:843-839-5289
Practice Address - Street 1:8210 DEVON CT # B
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29572-4178
Practice Address - Country:US
Practice Address - Phone:843-839-5328
Practice Address - Fax:843-839-5289
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD83485207W00000X
PAMD425755207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1080473OtherAETNA
PA1738873OtherHIGHMARK BC/BS
SC3331130OtherCIGNA
SC834850Medicaid
SC7230715OtherAETNA
PA1012981580001Medicaid
PA410684OtherUPMC
SC150888839424OtherHUMANA