Healthcare Provider Details
I. General information
NPI: 1134306566
Provider Name (Legal Business Name): ABRAHAM PALAMOOTIL THOMAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/29/2008
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 PATEWOOD DR STE B350
GREENVILLE SC
29615-6337
US
IV. Provider business mailing address
300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US
V. Phone/Fax
- Phone: 864-454-4500
- Fax: 864-454-4505
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | P7219 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 2025024055 |
| License Number State | MO |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 036172294 |
| License Number State | IL |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | 40035 |
| License Number State | SC |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | ME103219 |
| License Number State | FL |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | A119741 |
| License Number State | CA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084V0102X |
| Taxonomy | Vascular Neurology Physician |
| License Number | 036172294 |
| License Number State | IL |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084V0102X |
| Taxonomy | Vascular Neurology Physician |
| License Number | 40035 |
| License Number State | SC |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: