Individual
MICHAEL STANLEY THIBAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
25 TAMARACK AVENUE, ADVANCED DERM CARE, PC, DANBURY, CT 06811
(203) 797-8990
(203) 748-7861
Mailing address
25 TAMARACK AVENUE, ADVANCED DERM CARE, PC, DANBURY, CT 06811
(203) 797-8990
(203) 748-7861
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
001389
CT
207Q00000X
Family Medicine Physician
PA 1933
CO
363A00000X
Physician Assistant
Primary
1389
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA1933
PA LICENSE
CO
Enumeration date
05/19/2006
Last updated
01/16/2026
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