Individual
PAUL O THIEME JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
145 MICHIGAN ST NE STE 1100, GRAND RAPIDS, MI 49503-2562
(616) 486-5750
Mailing address
1895 M 28 E, MARQUETTE, MI 49855-9546
(906) 249-4942
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
010272
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4565403
—
MI
Enumeration date
11/15/2006
Last updated
12/09/2025
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