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Individual

JOHN E THORDSEN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4414 LAKE BOONE TRL STE 302, RALEIGH, NC 27607-7514
(197) 828-0389
(919) 782-8189
Mailing address
4414 LAKE BOONE TRL, 302, RALEIGH, NC 27607-7513
(919) 782-8038
(919) 782-8189

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
2011-00308
NC
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
2011-00308
NC

Other

Enumeration date
01/29/2007
Last updated
09/24/2020
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