Healthcare Provider Details

I. General information

NPI: 1437144714
Provider Name (Legal Business Name): THOMAS MICHAEL HOWARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2005
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 ASHVILLE AVE SUITE 330
CARY NC
27518-6134
US

IV. Provider business mailing address

1414 YANCEYVILLE ST SUITE 200
GREENSBORO NC
27405-6962
US

V. Phone/Fax

Practice location:
  • Phone: 919-371-2371
  • Fax: 919-371-2375
Mailing address:
  • Phone: 336-895-1598
  • Fax: 336-390-2170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number32116
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: