Individual
DR. OMER THIBODEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3 MEDICAL CENTER DR, BIDDEFORD, ME 04005-9422
(207) 284-4597
Mailing address
9 HEALTHCARE DR, BIDDEFORD, ME 04005-9449
(207) 282-9080
(207) 282-9080
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
7706
ME
208600000X
Surgery Physician
Primary
7706
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01 0398532
TRICARE
ME
01
—
1041542
AETNA
ME
05
—
114440000
—
ME
05
—
114440099
—
ME
05
—
30207619
—
NH
01
—
B86995
HARVARD PILGRIM
ME
Enumeration date
01/29/2007
Last updated
10/27/2009
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