Provider Demographics
NPI:1861477713
Name:THANDROYEN, FRANCIS TREVOR (MD, FACC)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:TREVOR
Last Name:THANDROYEN
Suffix:
Gender:M
Credentials:MD, FACC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 ROPER MOUNTAIN ROAD EXT
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4825
Mailing Address - Country:US
Mailing Address - Phone:864-509-6111
Mailing Address - Fax:864-509-6112
Practice Address - Street 1:218 ROPER MOUNTAIN ROAD EXT
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4825
Practice Address - Country:US
Practice Address - Phone:864-509-6111
Practice Address - Fax:864-509-6112
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20128207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2489Medicaid
060052285OtherRR MEDICARE
SC8758OtherMEDICARE GRP NUMBER
SCDG3188OtherRR MEDICARE GRP NUMBER
SC201285Medicaid
SCDG3188OtherRR MEDICARE GRP NUMBER
SCF27302Medicare UPIN