| Provider / Organization | NPI | Date Certified |
|---|---|---|
| STEPHAN G THIEDE | 1346277399 | 2024-07-05 |
Stephan G Thiede MD [M] graduated in 1998 from University Of North Carolina At Chapel Hill School Of Medicine and primarily specializes in Diagnostic Radiology.
Stephan G Thiede is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1346277399. Registration indicates Stephan G Thiede is a provider of services with a specialization in Diagnostic Radiology (Radiology) (Allopathic & Osteopathic Physicians, Radiology) (Radiology: Diagnostic Radiology, ) (Diagnostics/Imaging/Laboratory/Mammography, ) (Radiology Diagnostic Radiology, Allopathic & Osteopathic Physicians) (Radiology, ) (Diagnostic Radiology (Radiology),, ) (Allopathic & Osteopathic Physicians, Radiology) (Radiology: Diagnostic Radiology, ) (Diagnostics/Imaging/Laboratory/Mammography, ) (Radiology Diagnostic Radiology, Allopathic & Osteopathic Physicians) (Radiology, )
| PECOS ID | 2062494438 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Stephan G Thiede MD |
| Practice Office Address | 1200 HILYARD ST EUGENE, OR US |
| Practice Office Telephone | 5416877134 |
| Practice Office Fax | 5416877135 |
| Mailing Address | 445 HARLOW RD STE 200 SPRINGFIELD, OR 974771341 US |
| Business Telephone | 5413027771 |
| Code | Practice | License No State |
|---|---|---|
| 2085R0202X | Diagnostic Radiology (Radiology), Allopathic & Osteopathic Physicians Radiology Radiology: Diagnostic Radiology Diagnostics/Imaging/Laboratory/Mammography Radiology Diagnostic Radiology Allopathic & Osteopathic Physicians Radiology | MD60183001
WA |
| 2085R0202X PRIMARY | Diagnostic Radiology (Radiology), Allopathic & Osteopathic Physicians Radiology Radiology: Diagnostic Radiology Diagnostics/Imaging/Laboratory/Mammography Radiology Diagnostic Radiology Allopathic & Osteopathic Physicians Radiology | MD25991
OR |
| 8427338 | MEDICAID | WA | |
| 269934 | MEDICAID | OR | |
| MD4882R | MEDICAID | AK | |
| MD9882R | MEDICAID | AK |