Provider Demographics
NPI:1932101110
Name:THIELHELM, PHILIP H (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:H
Last Name:THIELHELM
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 1:55 HIGHLAND AVE.
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-2100
Mailing Address - Country:US
Mailing Address - Phone:978-745-4489
Mailing Address - Fax:978-354-2085
Practice Address - Street 1:55 HIGHLAND AVE.
Practice Address - Street 2:SUITE 104
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-2100
Practice Address - Country:US
Practice Address - Phone:978-745-4489
Practice Address - Fax:978-354-2085
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA41053207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Not Answered207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2056267Medicaid
MA2056267Medicaid
MAD28144Medicare ID - Type Unspecified