Provider Demographics
NPI:1811950173
Name:O'MEARA, THOMAS M (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:M
Last Name:O'MEARA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:624 QUAKER LN
Mailing Address - Street 2:SUITE 207 C
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3832
Mailing Address - Country:US
Mailing Address - Phone:336-883-2500
Mailing Address - Fax:336-883-9728
Practice Address - Street 1:2401 HICKSWOOD RD
Practice Address - Street 2:STE.104
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27265-1537
Practice Address - Country:US
Practice Address - Phone:336-884-6000
Practice Address - Fax:336-884-7222
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2011-08-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC9900311207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891193FMedicaid
NC2022021Medicare PIN
C66240Medicare UPIN