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General NPI Number Information
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NPI Number | 1386786531
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Entity Type | Organization
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Legal Business Name | PAUL D. THIELKING, M.D., P.C.
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Dates
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Enumeration Date | 02/13/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2345 S HURON PKWY
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City | ANN ARBOR
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State | MI
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Zip | 48104-5124
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Country | US
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Telephone | 734-904-4518
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Fax |
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Provider Business Mailing Address
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Address Line | 2345 S HURON PKWY
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City | ANN ARBOR
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State | MI
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Zip | 48104-5124
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Country | US
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Telephone | 734-904-4518
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL D. THIELKING
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Credential | M.D.
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Telephone | 734-904-4518
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 4301082207
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License Number State | MI
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