Lee L. Thibodeau MD

NPI 1063456523 - Neurological Surgery - 207T00000X

NPI Details
NPI 1063456523
Gender Male
Enumeration Date 06/15/2006
Last Updated 10/15/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
195 FORE RIVER PKWY
SUITE 490
PORTLAND ME, 04102-2780, US
Phone (207) 553-6054
Fax (207) 553-6076
Business Location
195 FORE RIVER PARKWAY
SUITE 490
PORTLAND ME, 04102-0000, US
Phone (207) 553-6054
Fax (207) 553-6076
Toxanomy
Taxonomy Code 207T00000X
License State Maine
License Number 012489
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According to our database, Lee L. Thibodeau MD NPI is 1063456523, taxonomy code is 207T00000X and license number is 012489, license state is located at Maine. Lee L. Thibodeau MD physically located at 195 Fore River Pkwy, Portland ME, 04102-2780. NPI Number Lee L. Thibodeau MD has the Individual type.

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1063456523 NPI number is provided on an as is basis without warranty of any kind. 1063456523 is maintained by the National Plan & Provider Enumeration System. The contents of Lee L. Thibodeau MD are for informational purposes only.