Thibodeau, Donna M
Thibodeau, Donna M is an individual health care provider with primary practice located at 2100 N Dr Martin Luther King Jr Blvd Clovis Plains Reg Med Ctr, Clovis NM 88101-9412. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Thibodeau, Donna M can be contacted via phone (505) 769-2141.Contact Information
Primary practice address
2100 N Dr Martin Luther King Jr Blvd Clovis Plains Reg Med Ctr
Clovis NM 88101-9412
Phone: (505) 769-2141
Fax: (505) 769-7337
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 86135 | New Mexico |
Profile Details
| NPI number | 1053440933 |
|---|---|
| LBN Legal business name | Thibodeau, Donna M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 5th, 2007 |
| Last updated | Mar 18th, 2009 - about 17 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 | 1053440933 | NPPES |
| New Mexico | MEDICAID | 37507 |
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