MEDICARE: CARL W THURMOND M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	037711	GA
2	207UN0901X	Nuclear Cardiology Physician	32168	SC
3	207UN0901X	Nuclear Cardiology Physician	037711	GA
4	207RC0000X	Cardiovascular Disease Physician	32168	SC
5	207R00000X	Internal Medicine Physician	32168	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AA66502603	OTHER	SC	MEDICARE PTAN
2	P00218467/CM0845	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386638518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARL W THURMOND M.D.

Provider Business Mailing Address
First Line	:	300 E MCBEE AVE FL 4
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29601-2842
Country	:	US
Telephone Number	:	864-695-6697
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 N SUMTER ST STE 202
Second Line	:
City	:	SUMTER
State	:	SC
Zip	:	29150-4975
Country	:	US
Telephone Number	:	803-774-9797
Fax Number	:	803-933-3012

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	01/12/2026

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Directions to “ CARL W THURMOND M.D.” Practice Location

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