Individual
MR. DAVID THOMAS THIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
414 WEST ROBERTSON ST, BRANDON, FL 33511
(813) 684-5255
(813) 654-7457
Mailing address
414 WEST ROBERTSON ST, BRANDON, FL 33511
(813) 684-5255
(813) 654-7457
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
ME0053739
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07862
BCBS
—
Enumeration date
08/30/2006
Last updated
07/08/2007
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