Basic Information
Provider Information
NPI: 1215954052
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GINN
FirstName: THOMAS
MiddleName: ADAM
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1035 LINCOLNTON RD
Address2:  
City: SALISBURY
State: NC
PostalCode: 281446277
CountryCode: US
TelephoneNumber: 7046389990
FaxNumber: 7046390785
Practice Location
Address1: 1035 LINCOLNTON RD
Address2:  
City: SALISBURY
State: NC
PostalCode: 281446277
CountryCode: US
TelephoneNumber: 7046389990
FaxNumber: 7046390785
Other Information
ProviderEnumerationDate: 07/17/2006
LastUpdateDate: 10/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/06/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207XS0106X200200226NCN Allopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
207X00000X200200226NCY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

ID Information
IDTypeStateIssuerDescription
590572405NC MEDICAID


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