Individual
DR. JAMES ALFRED THIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
707 S GREENVILLE WEST DR, GREENVILLE, MI 48838-3514
(616) 754-3001
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5101016857
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055221400
—
MD
05
—
102719503
—
PA
01
—
1609750
GATEWAY
PA
01
—
2711836
HIGHMARK BLUE SHIELD
PA
01
—
418502
UPMC
PA
Enumeration date
04/07/2007
Last updated
03/03/2021
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