Individual
MR. BRETT L THORSTAD
Active
Individual
MR. BRETT L THORSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
25159
TN
2085R0202X
Diagnostic Radiology Physician
Primary
MD25159
TN
2085R0204X
Vascular & Interventional Radiology Physician
25159
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1509319
MEDICAID - MTI
TN
05
—
1509319
—
TN
01
—
1600684
UNITED HEALTHCARE OF TN
TN
01
—
2644117
CIGNA
TN
01
—
300106387
RAILROAD MEDICARE
TN
05
—
3080836
—
TN
01
—
3102002
BCBS
TN
01
—
3135871
BCBS
TN
01
—
4076947
BCBS
TN
01
—
4201075
BCBS TN
TN
01
—
4291298
BCBS - MTI
TN
01
—
64917941
KY MEDICAID
KY
05
—
64917941
—
KY
Enumeration date
05/24/2006
Last updated
12/02/2011
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