Provider Demographics
NPI:1790869683
Name:PRICE, THOMAS
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:PRICE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5704 FAYETTEVILLE RD
Mailing Address - Street 2:DUKE FERTILITY CENTER
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-9089
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5704 FAYETTEVILLE RD
Practice Address - Street 2:DUKE FERTILITY CENTER
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-9089
Practice Address - Country:US
Practice Address - Phone:919-572-4673
Practice Address - Fax:919-484-0461
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32955207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2012313Medicare ID - Type Unspecified
NC89133HRMedicare ID - Type Unspecified
E48647Medicare ID - Type Unspecified