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Individual

MATTHEW THOMAS THIMLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
4151 E 96TH ST, INDIANAPOLIS, IN 46240-1442
(866) 434-3255
Mailing address
4151 E 96TH ST, INDIANAPOLIS, IN 46240-1442
(866) 434-3255

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
363AM0700X
Medical Physician Assistant
Primary
10001621A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200079040C
MEDICAID GROUP
IN
Enumeration date
05/30/2013
Last updated
01/29/2018
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