Healthcare Provider Details

I. General information

NPI: 1871549865
Provider Name (Legal Business Name): THOMAS A DUC MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 08/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 FARMFIELD AVE SUITE B
CHARLESTON SC
29407-7779
US

IV. Provider business mailing address

8 FARMFIELD AVE SUITE B
CHARLESTON SC
29407-7779
US

V. Phone/Fax

Practice location:
  • Phone: 843-266-9298
  • Fax: 843-266-9299
Mailing address:
  • Phone: 843-266-9298
  • Fax: 843-266-9299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number13634
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: