Provider Demographics
NPI:1891745303
Name:POPE, THOMAS DAVID (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:DAVID
Last Name:POPE
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 1:2209 S STERLING ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28655-4091
Mailing Address - Country:US
Mailing Address - Phone:828-580-4661
Mailing Address - Fax:828-580-4698
Practice Address - Street 1:2209 S STERLING ST
Practice Address - Street 2:SUITE 400
Practice Address - City:MORGANTON
Practice Address - State:NC
Practice Address - Zip Code:28655-4091
Practice Address - Country:US
Practice Address - Phone:828-580-4661
Practice Address - Fax:828-580-4698
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2010-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23421174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8968474Medicaid
NC202170BMedicare ID - Type Unspecified
NC202170CMedicare PIN
NC8968474Medicaid