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General NPI Number Information
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NPI Number | 1669455192
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Entity Type | Individual
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Provider Name | MICHAEL A THURSBY DO
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Gender | Male
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Dates
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Enumeration Date | 11/29/2005
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Last Update Date | 08/11/2020
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Provider Practice Location Address
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Address Line | 318 WATERMAN AVE
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914
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Country | US
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Telephone | 401-438-5950
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Fax | 401-435-6700
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Provider Business Mailing Address
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Address Line | 318 WATERMAN AVE
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City | EAST PROVIDENCE
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State | RI
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Zip | 02914-3525
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Country | US
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Telephone | 401-438-5950
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Fax | 401-435-2245
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 213316
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 00502
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License Number State | RI
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