Individual
MICHELE THIEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
(218) 732-2874
Mailing address
PO BOX 6001, FARGO, ND 58108-6001
(701) 364-3300
(701) 364-8906
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
45713
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040974000
—
MN
Enumeration date
10/11/2006
Last updated
02/11/2014
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