Provider Demographics
NPI:1548429871
Name:SAULLO, THOMAS ROBERT (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ROBERT
Last Name:SAULLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 38186
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27438-8186
Mailing Address - Country:US
Mailing Address - Phone:336-333-6306
Mailing Address - Fax:336-333-6309
Practice Address - Street 1:2105 BRAXTON LN
Practice Address - Street 2:SUITE 101
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-2861
Practice Address - Country:US
Practice Address - Phone:336-333-6306
Practice Address - Fax:336-333-6309
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY247033208100000X
VA0101246867208100000X
NC201101502208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation