Provider Demographics
NPI:1750957965
Name:NADEAU, THOMAS HUNTER (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:HUNTER
Last Name:NADEAU
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 MARINERS FRY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5808
Mailing Address - Country:US
Mailing Address - Phone:207-436-5324
Mailing Address - Fax:
Practice Address - Street 1:10160 DORCHESTER RD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-2948
Practice Address - Country:US
Practice Address - Phone:843-851-5820
Practice Address - Fax:843-832-6403
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2022-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10692225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1750957965Medicaid