Individual
LARRY F THIESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
363 HIGHLAND AVE, FALL RIVER, MA 02720-3703
(508) 973-7558
(508) 973-7147
Mailing address
200 MILL RD, SUITE 180, FAIRHAVEN, MA 02719-5252
(508) 973-2000
(508) 973-2002
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
209411
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0199290
—
MA
Enumeration date
07/28/2005
Last updated
04/27/2020
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