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Individual

STEPHAN G THIEDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 HILYARD ST, EUGENE, OR 97401-8122
(541) 687-7134
(541) 687-7135
Mailing address
445 HARLOW RD STE 200, SPRINGFIELD, OR 97477-1341
(541) 302-7771

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD25991
OR
2085R0202X
Diagnostic Radiology Physician
MD60183001
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
269934
OR
05
8427338
WA
05
MD4882R
AK
05
MD9882R
AK
Enumeration date
06/26/2006
Last updated
07/05/2024
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