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NPI Code Detail

MEDICARE: DR. THOMAS EDWARD THIELEN MD

MEDICARE: DR. THOMAS EDWARD THIELEN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician116729NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1116729OTHERNCNORTH CAROLINA MEDICAL BOARD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356440028
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS EDWARD THIELEN MD
Provider Business Mailing Address
First Line : 300 BETHESDA DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-7218
Country : US
Telephone Number : 252-752-7141
Fax Number : 252-752-0223
Provider Business Practice Location Address
First Line : 300 BETHESDA DR
Second Line :
City : GREENVILLE
State : NC
Zip : 27834-7218
Country : US
Telephone Number : 252-752-7141
Fax Number : 252-752-0223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/21/2006
Last Update Date : 06/24/2016

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