Individual
GREGORY THIBODEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
76 HIGH ST, LEWISTON, ME 04240-7649
(207) 795-2800
Mailing address
76 HIGH ST, LEWISTON, ME 04240-7649
(207) 795-2800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
EC131109
ME
Other
Enumeration date
07/09/2013
Last updated
07/09/2013
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