Healthcare Provider Details

I. General information

NPI: 1811956915
Provider Name (Legal Business Name): THOMAS W HEPFER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 N SUMTER ST SUITE 200
SUMTER SC
29150-4972
US

IV. Provider business mailing address

PO BOX 1469
SUMTER SC
29151-1469
US

V. Phone/Fax

Practice location:
  • Phone: 803-775-8351
  • Fax: 803-773-2635
Mailing address:
  • Phone: 803-775-8351
  • Fax: 803-773-2635

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number7806
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: