Individual
DR. RICHARD P THIEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2323 N LAKE DR, MILWAUKEE, WI 53211-4508
(414) 270-4932
Mailing address
4425 N PORT WASHINGTON RD, DEPARTMENT OF INTERNAL MEDICINE, MILWAUKEE, WI 53212-1082
(414) 326-2218
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
62929
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4644006
—
MI
Enumeration date
09/23/2006
Last updated
09/10/2014
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