Basic Information
Provider Information
NPI: 1619959459
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: STOHRER
FirstName: THOMAS
MiddleName: W.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 12065
Address2:  
City: NEW BERN
State: NC
PostalCode: 285612065
CountryCode: US
TelephoneNumber: 2526335057
FaxNumber: 2526330084
Practice Location
Address1: 720 NEWMAN RD
Address2:  
City: NEW BERN
State: NC
PostalCode: 285625238
CountryCode: US
TelephoneNumber: 2526335057
FaxNumber: 2526330084
Other Information
ProviderEnumerationDate: 11/17/2005
LastUpdateDate: 11/21/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X34170NCY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
2085R0204X34170NCN Allopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
2085B0100X34170NCN Allopathic & Osteopathic PhysiciansRadiologyBody Imaging
2085D0003X34170NCN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging
2085U0001X34170NCN Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound
2085N0700X34170NCN Allopathic & Osteopathic PhysiciansRadiologyNeuroradiology
2085N0904X34170NCN Allopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
2085P0229X34170NCN Allopathic & Osteopathic PhysiciansRadiologyPediatric Radiology
2085R0001X34170NCN Allopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
2085R0205X34170NCN Allopathic & Osteopathic PhysiciansRadiologyRadiological Physics
2085R0203X34170NCN Allopathic & Osteopathic PhysiciansRadiologyTherapeutic Radiology
207U00000X34170NCN Allopathic & Osteopathic PhysiciansNuclear Medicine 

ID Information
IDTypeStateIssuerDescription
898020305NC MEDICAID
C518501NCMEDCOSTOTHER
14812501NCVYTRAOTHER
76015801NCMAMSIOTHER
8020301NCBCBS OF NCOTHER
15300050001NCDOLOTHER


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