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Individual

WILLIAM J THIEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1217 E ELIZABETH ST STE 1, FORT COLLINS, CO 80524-4040
(970) 484-7495
(970) 484-1398
Mailing address
1217 E ELIZABETH ST STE 1, FORT COLLINS, CO 80524-4040

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DR-19190
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01191907
CO
Enumeration date
10/24/2006
Last updated
11/08/2007
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