Individual
DAVID A THANHAUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
75 NORTHPORT AVE, BELFAST, ME 04915-6000
(207) 338-3995
Mailing address
75 NORTHPORT AVE, BELFAST, ME 04915-6000
(207) 338-3995
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
008077
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004528
ANTHEM
ME
01
—
1044415
AETNA
ME
05
—
108540000
—
ME
01
—
441081452
RAILROAD MEDICARE
ME
01
—
M75540
CIGNA
ME
Enumeration date
06/30/2006
Last updated
07/02/2010
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