Healthcare Provider Details

I. General information

NPI: 1245763242
Provider Name (Legal Business Name): ALEXANDER THOMAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/06/2017
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF SURGERY 30 COURTENAY DRIVE MSC 295
CHARLESTON SC
29425-0001
US

IV. Provider business mailing address

PO BOX 751461
CHARLOTTE NC
28275-1461
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-1414
  • Fax:
Mailing address:
  • Phone: 843-792-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number97353
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number307823
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: