Basic Information
Provider Information
NPI: 1396185039
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THURMAN
FirstName: CHAD
MiddleName: ROBERT
NamePrefix: DR.
NameSuffix:  
Credential: D.O
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1005 E CHEVES ST
Address2:  
City: FLORENCE
State: SC
PostalCode: 295062707
CountryCode: US
TelephoneNumber: 8437777900
FaxNumber: 8437777925
Practice Location
Address1: 1005 E CHEVES ST
Address2:  
City: FLORENCE
State: SC
PostalCode: 295062707
CountryCode: US
TelephoneNumber: 8437777900
FaxNumber: 8437777925
Other Information
ProviderEnumerationDate: 06/26/2013
LastUpdateDate: 02/22/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/22/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X5101020521MIN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207X00000X007472AZN Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207X00000X82107SCY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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