| Thomas A Upshaw, Md, Pa | |
|
728 S Shelmore Blvd Ste 103 Mt Pleasant SC 29464-1601 | |
| (843) 972-0262 | |
| (843) 972-0263 |
| Full Name | Thomas A Upshaw, Md, Pa |
|---|---|
| Speciality | Clinic/Center |
| Location | 728 S Shelmore Blvd Ste 103, Mt Pleasant, South Carolina |
| Authorized Official Name and Position | Thomas A Upshaw (PRESIDENT) |
| Authorized Official Contact | 8437544655 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas A Upshaw, Md, Pa 1336 Newport Ct Daniel Island SC 29492-8262 Ph: (843) 754-4655 | Thomas A Upshaw, Md, Pa 728 S Shelmore Blvd Ste 103 Mt Pleasant SC 29464-1601 Ph: (843) 972-0262 |
| NPI Number | 1669727566 |
|---|---|
| Provider Enumeration Date | 07/17/2012 |
| Last Update Date | 09/18/2023 |
| Certification Date | 09/18/2023 |
| Medicare PECOS PAC ID | 5799941688 |
|---|---|
| Medicare Enrollment ID | O20120720000458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669727566 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 18101 (South Carolina) | Primary |
| Provider Name | Thomas Arthur Upshaw |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306002142 PECOS PAC ID: 4082694328 Enrollment ID: I20040726000681 |
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