Thevaos, George P

Thevaos, George P is an individual health care provider with primary practice located at 1994 Wellness Blvd Suite 110, Monroe NC 28110-7767. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Thevaos, George P can be contacted via phone (704) 384-8460.

Contact Information

Primary practice address
1994 Wellness Blvd Suite 110 Monroe NC 28110-7767
Phone: (704) 384-8460
Fax: (704) 384-8465
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 9900139 North Carolina

Profile Details

NPI number 1619966298
LBN Legal business name Thevaos, George P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2005
Last updated Oct 28th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619966298 NPPES
South Carolina MEDICAID N00134
South Carolina MEDICAID 891238N

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