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NPI Code Detail

MEDICARE: DR. LOUISE A THIELEN MD

MEDICARE: DR. LOUISE A 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
1207Q00000XFamily Medicine Physician31052CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2370006298OTHERCORAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1659474625
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LOUISE A THIELEN MD
Provider Business Mailing Address
First Line : 1475 PINE GROVE RD
Second Line : SUITE 102
City : STEAMBOAT SPRINGS
State : CO
Zip : 80487-8803
Country : US
Telephone Number : 970-879-0203
Fax Number : 970-879-1389
Provider Business Practice Location Address
First Line : 1475 PINE GROVE RD
Second Line : SUITE 102
City : STEAMBOAT SPRINGS
State : CO
Zip : 80487-8803
Country : US
Telephone Number : 970-879-0203
Fax Number : 970-879-1389
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2006
Last Update Date : 03/01/2016

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Directions to “ DR. LOUISE A THIELEN MD” Practice Location

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