MEDICARE: DR. THOMAS JOHN CHAMBERS MD

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	207X00000X	Orthopaedic Surgery Physician	18818	SC
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	18818	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	CE6164	OTHER	SC	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	A-165	OTHER	NC	NC UHC
3	0903621	OTHER	SC	PHYSICIANS HEALTH PLAN
4	1044182	OTHER	SC	FIRST HEALTH
5	#15	OTHER	SC	UHC
6	3611017001	OTHER	SC	CIGNA
7	72853	OTHER	SC	MEDCOST

General Provider Information

NPI Number	:	1972560738
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS JOHN CHAMBERS MD

Provider Business Mailing Address
First Line	:	210 VILLAGE CENTER BLVD STE 140
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-6706
Country	:	US
Telephone Number	:	843-353-3460
Fax Number	:	843-353-3461

Provider Business Practice Location Address
First Line	:	210 VILLAGE CENTER BLVD STE 200
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-6706
Country	:	US
Telephone Number	:	843-353-3460
Fax Number	:	843-353-3461

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	07/20/2022

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Directions to “ DR. THOMAS JOHN CHAMBERS MD” Practice Location

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