Provider Demographics
NPI:1386605574
Name:MARSH, THOMAS DAVID (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:DAVID
Last Name:MARSH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3 RICHLAND MEDICAL PARK
Mailing Address - Street 2:SUITE 400
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203
Mailing Address - Country:US
Mailing Address - Phone:803-434-6392
Mailing Address - Fax:803-434-4309
Practice Address - Street 1:5 RICHLAND MEDICAL PARK
Practice Address - Street 2:PALMETTO HEALTH RICHLAND
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203
Practice Address - Country:US
Practice Address - Phone:803-434-7151
Practice Address - Fax:803-434-6401
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC1154592080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3457Medicaid
SCGP3457Medicaid