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General NPI Number Information
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NPI Number | 1215970769
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Entity Type | Individual
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Provider Name | BRUCE G THORKILDSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 07/27/2007
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Provider Practice Location Address
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Address Line | 2597 SCHOENERSVILLE RD SUITE #308
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City | BETHLEHEM
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State | PA
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Zip | 18017-7325
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Country | US
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Telephone | 610-691-6565
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Fax | 610-691-7580
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Provider Business Mailing Address
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Address Line | 2597 SCHOENERSVILLE RD SUITE #308
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City | BETHLEHEM
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State | PA
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Zip | 18017-7325
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Country | US
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Telephone | 610-691-6565
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Fax | 610-691-7580
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD046529L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 155421
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License Number State | NY
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