Provider Demographics
NPI:1871549865
Name:DUC, THOMAS A (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:A
Last Name:DUC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:8 FARMFIELD AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7779
Mailing Address - Country:US
Mailing Address - Phone:843-266-9298
Mailing Address - Fax:843-266-9299
Practice Address - Street 1:8 FARMFIELD AVE
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7779
Practice Address - Country:US
Practice Address - Phone:843-266-9298
Practice Address - Fax:843-266-9299
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2012-08-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SC13634207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC136347Medicaid
SC136347Medicaid
SCE127081459Medicare ID - Type Unspecified