Individual
MARK ROBERT THIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(678) 216-0771
Mailing address
1180 CASTLE POINTE LN, GRAYSON, GA 30017-1077
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
6963
GA
Other
Enumeration date
02/09/2013
Last updated
05/30/2023
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