Individual
MR. MATTHEW L THIBDEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
300 EXEMPLA CIR, SUITE 360, LAFAYETTE, CO 80026-3397
(303) 689-6560
(303) 689-6550
Mailing address
300 EXEMPLA CIR, SUITE 360, LAFAYETTE, CO 80026-3397
(303) 689-6560
(303) 689-6550
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA-3205
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
97708585
—
CO
Enumeration date
09/12/2007
Last updated
09/13/2011
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