MEDICARE: WILLIAM THIEMKEY D.O.

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
1	207P00000X	Emergency Medicine Physician	2005-01802	NC
2	208D00000X	General Practice Physician	WT007666	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00418628	OTHER		RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1962407288
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM THIEMKEY D.O.

Provider Business Mailing Address
First Line	:	44 HUNTING LODGE DR
Second Line	:
City	:	BLACK MOUNTAIN
State	:	NC
Zip	:	28711-9799
Country	:	US
Telephone Number	:	828-669-4485
Fax Number	:

Provider Business Practice Location Address
First Line	:	NAPLES RD
Second Line	:
City	:	FLETCHER
State	:	NC
Zip	:	28732
Country	:	US
Telephone Number	:	828-681-2141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	05/20/2008

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Directions to “ WILLIAM THIEMKEY D.O.” Practice Location

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