Provider Demographics
NPI:1518914894
Name:HAHM, THOMAS (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:HAHM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 WINGO WAY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-1810
Mailing Address - Country:US
Mailing Address - Phone:843-884-1400
Mailing Address - Fax:843-884-7448
Practice Address - Street 1:180 WINGO WAY
Practice Address - Street 2:SUITE 205
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-1810
Practice Address - Country:US
Practice Address - Phone:843-884-1400
Practice Address - Fax:843-884-7448
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC267292086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7941OtherMEDICARE PTIN
SCGP3944 SCMedicaid
SCGP3944 SCMedicaid