Thieme, Dan C.
Thieme, Dan C. is an individual health care provider with primary practice located at 1648 Nw 2Nd St , Meridian ID 83642-2224. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Thieme, Dan C. can be contacted via phone (208) 888-2200.Contact Information
Primary practice address
1648 Nw 2Nd St
Meridian ID 83642-2224
Phone: (208) 888-2200
Fax: (208) 888-7623
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | ODP-901 | Idaho |
Profile Details
| NPI number | 1245243245 |
|---|---|
| LBN Legal business name | Thieme, Dan C. |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 14th, 2006 |
| Last updated | May 2nd, 2019 - about 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245243245 | NPPES |
| Idaho | Other | V902-2 | BLUE CROSS |
| Idaho | Other | 000010015459 | BLUE CROSS |
| Idaho | MEDICAID | 001519300 | BLUE CROSS |
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