Provider Demographics
NPI:1831391945
Name:THOMAS, BENJAMIN MICHAEL (MD)
Entity type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:MICHAEL
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1985 TATE BLVD SE STE 600
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28602-1433
Mailing Address - Country:US
Mailing Address - Phone:828-328-5500
Mailing Address - Fax:828-485-2517
Practice Address - Street 1:1985 TATE BLVD SE STE 600
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-1433
Practice Address - Country:US
Practice Address - Phone:828-328-5500
Practice Address - Fax:828-485-2517
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2010-000502084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNC #2010-00050OtherNC MEDICAL LICENSE