Basic Information
| Provider Information | |||||||||
| NPI: | 1639605330 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOLDEN | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | MICHAEL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 US HIGHWAY 70 EAST | ||||||||
| Address2: | |||||||||
| City: | GARNER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192356400 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 400 US HWY 70 EAST | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | GARNER | ||||||||
| State: | NC | ||||||||
| PostalCode: | 27529 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9192356400 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2017 | ||||||||
| LastUpdateDate: | 07/22/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/13/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | TL.0006537 | CO | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 2022-00540 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.