Provider Demographics
NPI:1790871069
Name:GINN, THOMAS MOSS (MD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:MOSS
Last Name:GINN
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 1:319 MOCKSVILLE AVENUE
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:NC
Mailing Address - Zip Code:28144
Mailing Address - Country:US
Mailing Address - Phone:704-637-3538
Mailing Address - Fax:704-637-7793
Practice Address - Street 1:319 MOCKSVILLE AVENUE
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28144
Practice Address - Country:US
Practice Address - Phone:704-637-3538
Practice Address - Fax:704-637-7793
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8935658Medicaid
0441123OtherUNITED HEALTH CARE
35658OtherBCBS
NC8935658Medicaid
0441123OtherUNITED HEALTH CARE