Thibault, Michael Stanley

Thibault, Michael Stanley is an individual health care provider with primary practice located at 25 Tamarack Avenue Advanced Derm Care, Pc, Danbury CT 06811. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Thibault, Michael Stanley can be contacted via phone (203) 797-8990.

Contact Information

Primary practice address
25 Tamarack Avenue Advanced Derm Care, Pc Danbury CT 06811
Phone: (203) 797-8990
Fax: (203) 748-7861
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X PA 1933 Colorado
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 001389 Connecticut

Profile Details

NPI number 1659324515
LBN Legal business name Thibault, Michael Stanley
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date May 19th, 2006
Last updated Oct 3rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659324515 NPPES
Colorado Other PA1933 PA LICENSE

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