Thomas Gansman, MD | |
557 Brookdale Dr, Statesville, NC 28677-4107 | |
(317) 502-9920 | |
Not Available |
Full Name | Thomas Gansman |
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Gender | Male |
Speciality | Emergency Medicine |
Location | 557 Brookdale Dr, Statesville, North Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023024569 | NPI | - | NPPES |
200205180 | Medicaid | IN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | 2012-00515 (North Carolina) | Primary |
Entity Name | Lafayette Emergency Physicians Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891741641 PECOS PAC ID: 9931172863 Enrollment ID: O20040818000317 |
Entity Name | Icem-wishard Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629304134 PECOS PAC ID: 8224162441 Enrollment ID: O20100810000590 |
Mailing Address | Practice Location Address |
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Thomas Gansman, MD 147 E Cold Hollow Farms Dr, Mooresville, NC 28117-6725 Ph: (317) 502-9920 | Thomas Gansman, MD 557 Brookdale Dr, Statesville, NC 28677-4107 Ph: (317) 502-9920 |
Darshan Babubhai Patel, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 293 Old Mocksville Rd, Statesville, NC 28625 Phone: 704-872-8711 | |
Jonathan Torres, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 557 Brookdale Dr, Statesville, NC 28677 Phone: 704-437-0429 |