Provider Demographics
NPI:1710963434
Name:THIEME, RALPH W (DO)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:W
Last Name:THIEME
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6071
Mailing Address - Street 2:
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-6071
Mailing Address - Country:US
Mailing Address - Phone:207-781-6560
Mailing Address - Fax:207-839-2197
Practice Address - Street 1:66 LEIGHTON RD
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-2225
Practice Address - Country:US
Practice Address - Phone:207-781-6560
Practice Address - Fax:207-781-6561
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME1596204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME4336070OtherCIGNA
MEAA5728OtherHARVARD PILGRIM
ME047280OtherANTHEM
ME326760000Medicaid
ME3443842OtherAETNA
ME4336070OtherCIGNA