Provider Demographics
NPI:1821084294
Name:THESING, MICHAEL JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:JOSEPH
Last Name:THESING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 EUCLID AVE STE 409
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-2981
Mailing Address - Country:US
Mailing Address - Phone:619-267-8313
Mailing Address - Fax:619-472-2008
Practice Address - Street 1:655 EUCLID AVE STE 409
Practice Address - Street 2:
Practice Address - City:NATIONAL CITY
Practice Address - State:CA
Practice Address - Zip Code:91950-2981
Practice Address - Country:US
Practice Address - Phone:619-267-8313
Practice Address - Fax:619-472-2008
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG164057207VX0000X
OH35.058885207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0908978Medicaid
E77451Medicare UPIN
OHTH0680401Medicare ID - Type Unspecified
OHH070920Medicare PIN