Individual
TIMOTHY C THUNDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD22487
OR
208M00000X
Hospitalist Physician
MD22487
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110219893
RR MEDICARE - PHS
OR
05
—
288357
—
OR
Enumeration date
07/09/2006
Last updated
11/25/2020
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