Healthcare Provider Details

I. General information

NPI: 1942258231
Provider Name (Legal Business Name): THOMAS M STURGIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/05/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2465 EMERALD PL
GREENVILLE NC
27834-5785
US

IV. Provider business mailing address

2465 EMERALD PL
GREENVILLE NC
27834-5785
US

V. Phone/Fax

Practice location:
  • Phone: 252-758-2424
  • Fax: 252-758-0424
Mailing address:
  • Phone: 252-758-2424
  • Fax: 252-758-0424

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number35763
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: