Individual
MR. SCOTT ALLEN THIELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3016 W WACKERLY ST, MIDLAND, MI 48640-6160
(989) 631-6730
(989) 631-4968
Mailing address
3016 W WACKERLY ST, MIDLAND, MI 48640-6160
(989) 631-6730
(989) 631-4968
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301050197
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1605608302
BCBSM
MI
05
—
1993925
—
MI
01
—
382029531051
COMMUNITY CHOICE
MI
Enumeration date
11/16/2006
Last updated
10/24/2007
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