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Individual

DR. MARK A THIMINEUR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
130 DIVISION ST, 1ST FLOOR, DERBY, CT 06418
(203) 732-1570
(203) 732-1576
Mailing address
130 DIVISION ST, 1ST FLOOR, DERBY, CT 06418
(203) 732-1570
(203) 732-1576

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
033132
CT
208VP0014X
Interventional Pain Medicine Physician
Primary
033132
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001331321
CT
01
00133132101
BLUECARE FAMILY PLAN
CT
01
010033132CT02
BLUE CROSS BLUE SHIELD
CT
01
0V0370
HEALTHNET
CT
01
223514271
HMC/PPO
CT
01
3149086006
CIGNA
CT
01
4569760
AETNA
CT
01
764977
CONNECTICARE
CT
01
A752119
OXFORD
CT
01
HEALTH CONNECTICUT P
223514271
CT
Enumeration date
06/09/2006
Last updated
07/09/2010
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