Individual
DR. THADDEUS MICHAEL NORRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 W 35TH ST, GARDEN CITY, ID 83714-6520
(503) 704-2415
Mailing address
2000 S MYERS ST, BOISE, ID 83706-4008
(503) 704-1415
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MV-0023
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MV-0023
MEDICAL LICENSE
ID
Enumeration date
03/01/2006
Last updated
02/23/2023
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