Provider Demographics
NPI:1952626764
Name:THOMAS, CARMEN PEARSON (MD)
Entity Type:Individual
Prefix:MRS
First Name:CARMEN
Middle Name:PEARSON
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:510 N ELAM AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27403-1150
Mailing Address - Country:US
Mailing Address - Phone:336-299-3183
Mailing Address - Fax:336-299-1762
Practice Address - Street 1:510 N ELAM AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27403-1150
Practice Address - Country:US
Practice Address - Phone:336-299-3183
Practice Address - Fax:336-299-1762
Is Sole Proprietor?:No
Enumeration Date:2010-04-05
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2012-02084208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics