Provider Demographics
NPI:1881264299
Name:THIAB, GHADAH (MD)
Entity type:Individual
Prefix:
First Name:GHADAH
Middle Name:
Last Name:THIAB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 CONGAREE DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-6007
Mailing Address - Country:US
Mailing Address - Phone:919-986-0968
Mailing Address - Fax:
Practice Address - Street 1:7228 MONCURE PITTSBORO RD
Practice Address - Street 2:
Practice Address - City:MONCURE
Practice Address - State:NC
Practice Address - Zip Code:27559-9595
Practice Address - Country:US
Practice Address - Phone:919-986-0968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2024-00391207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine