Provider Demographics
NPI:1770579666
Name:SPIEGEL, THOMAS (PA)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:SPIEGEL
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FIRSTHEALTH INFECTIOUS DISEASES
Mailing Address - Street 2:35 MEMORIAL DRIVE
Mailing Address - City:PINEHURST
Mailing Address - State:NC
Mailing Address - Zip Code:28374-8708
Mailing Address - Country:US
Mailing Address - Phone:910-715-5481
Mailing Address - Fax:910-235-7972
Practice Address - Street 1:FIRSTHEALTH INFECTIOUS DISEASES
Practice Address - Street 2:35 MEMORIAL DRIVE
Practice Address - City:PINEHURST
Practice Address - State:NC
Practice Address - Zip Code:28374-8708
Practice Address - Country:US
Practice Address - Phone:910-715-5481
Practice Address - Fax:910-235-7972
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-001759363A00000X
NC0010-06848363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
K09883Medicare ID - Type Unspecified
P65123Medicare UPIN