Provider Demographics
NPI:1609941343
Name:WROTH, THOMAS H (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:H
Last Name:WROTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:143 W FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-2539
Mailing Address - Country:US
Mailing Address - Phone:919-966-8596
Mailing Address - Fax:919-843-5515
Practice Address - Street 1:221 N GRAHAM HOPEDALE RD
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2971
Practice Address - Country:US
Practice Address - Phone:336-570-3739
Practice Address - Fax:919-933-9201
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0098-00739207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8911355Medicaid
NC8911355Medicaid
NC2254184Medicare ID - Type Unspecified