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NPI Code Detail

MEDICARE: TERA THOMAS PA-C

MEDICARE:   TERA  THOMAS  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant0010-12852NC
2363A00000XPhysician Assistant

General Provider Information

NPI Number : 1780395210
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERA THOMAS PA-C
Provider Business Mailing Address
First Line : 2340 SPRING FOREST RD
Second Line :
City : RALEIGH
State : NC
Zip : 27615-7528
Country : US
Telephone Number : 919-781-8606
Fax Number :
Provider Business Practice Location Address
First Line : 2340 SPRING FOREST RD
Second Line :
City : RALEIGH
State : NC
Zip : 27615-7528
Country : US
Telephone Number : 919-790-6401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2022
Last Update Date : 12/18/2025

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Directions to “ TERA THOMAS PA-C” Practice Location

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