Salvador Mireles Thorn, PA-C
Physician Assistant in Fort Liberty, NC. Individual provider (NPI-1).
NPI number1982121059
StatusActive
Last updated in NPPESDec 10, 2024
Details
- NPI
- 1982121059
- Entity type
- Individual (NPI-1)
- Name
- Salvador Mireles Thorn
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 29, 2017
- Certification date
- Dec 10, 2024
- Last updated
- Dec 10, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 0010-11074 | NC | Yes |
| 363A00000X | Physician Assistant | – | – |
Other names
- Salvador Mireles Thorn (Other Name)
Practice location
Womack Army Medical Center 2817 Rock Merritt AvenueFort Liberty, NC 28310-0001
Phone 910-907-8922 · Fax 910-907-6069
Mailing address
2817 Rock Merritt Avenue Womack Army Medical CenterFort Liberty, NC 28310-4994
Phone 910-907-8922 · Fax 910-907-6069
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