MEDICARE: DR. THOMAS VAUGHN GIGUIERE M.D.

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
1	390200000X	Student in an Organized Health Care Education/Training Program		OH
2	207Q00000X	Family Medicine Physician	2015-01549	NC

General Provider Information

NPI Number	:	1932468980
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS VAUGHN GIGUIERE M.D.

Provider Business Mailing Address
First Line	:	902B ROANOKE AVE
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-5565
Country	:	US
Telephone Number	:	252-368-8575
Fax Number	:	833-671-0476

Provider Business Practice Location Address
First Line	:	902B ROANOKE AVE
Second Line	:
City	:	ELIZABETH CITY
State	:	NC
Zip	:	27909-5565
Country	:	US
Telephone Number	:	252-368-8575
Fax Number	:	888-216-0035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2012
Last Update Date	:	12/29/2022

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