Lee L. Thibodeau
Neurosurgeon
195 Fore River Pkwy Suite 490
Portland
, Maine 04102-2780
Lee L. Thibodeau
Neurosurgeon
195 Fore River Pkwy Suite 490
Portland
, Maine 04102-2780
(207) 553-6076
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About
Features
Specialties
- Neurosurgeon
Languages spoken
- English
Location
First Address
- Lee L. Thibodeau
- 195 Fore River Parkway Suite 490
- Portland, ME
- Zip : 04102-0000
- Fax : (207) 553-6076
- Phone : (207) 553-6054
Second Address
- Lee L. Thibodeau
- 195 Fore River Pkwy Suite 490
- Portland, ME
- Zip : 04102-2780
- Fax : (207) 553-6076
- Phone : (207) 553-6054
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207T00000X | Neurosurgeon | 012489 | ME |
National Provider Identifier
| NPI | 1063456523 |
|---|---|
| Provider Name | Lee L. Thibodeau |
| First Address | Portland, ME 04102-0000 |
| Second Address | Portland, ME 04102-2780 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/06/2006 |
| Last Update Date | 15/10/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 245520099 | (05) | ME |
| 30003392 | (05) | NH |
| B86452 | (02) | ME |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.