MEDICARE: DR. THOMAS EGAN 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	27750	SC

General Provider Information

NPI Number	:	1427043611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS EGAN M.D.

Provider Business Mailing Address
First Line	:	3581 HENRIETTA HARTFORD RD
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-7012
Country	:	US
Telephone Number	:	843-860-5394
Fax Number	:

Provider Business Practice Location Address
First Line	:	3581 HENRIETTA HARTFORD RD
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29466-7012
Country	:	US
Telephone Number	:	843-860-5394
Fax Number	:

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	07/08/2007

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