Provider Demographics
NPI:1932468980
Name:GIGUIERE, THOMAS VAUGHN (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:VAUGHN
Last Name:GIGUIERE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:902B ROANOKE AVE
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-5565
Mailing Address - Country:US
Mailing Address - Phone:252-368-8575
Mailing Address - Fax:833-671-0476
Practice Address - Street 1:902B ROANOKE AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-5565
Practice Address - Country:US
Practice Address - Phone:252-368-8575
Practice Address - Fax:888-216-0035
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
NC2015-01549207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program