Thornberg, Gary

Thornberg, Gary is an individual health care provider with primary practice located at 149 North St , Waterville ME 04901-4974. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Thornberg, Gary can be contacted via phone (207) 622-1959.

Contact Information

Primary practice address
149 North St Waterville ME 04901-4974
Phone: (207) 622-1959
Fax: (207) 430-4007
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 025911 Maine

Profile Details

NPI number 1821037052
LBN Legal business name Thornberg, Gary
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 5th, 2006
Last updated Dec 18th, 2013 - about 12 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 1821037052 NPPES
Maine MEDICAID 274300099

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