Thornblade, S Michelle

Thornblade, S Michelle is an individual health care provider with primary practice located at 3975 Saint Charles Pkwy , Waldorf MD 20602-2683. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Thornblade, S Michelle can be contacted via phone (301) 645-6800.

Contact Information

Primary practice address
3975 Saint Charles Pkwy Waldorf MD 20602-2683
Phone: (301) 645-6800
Fax: (301) 645-8696
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X C0002969 Maryland

Profile Details

NPI number 1629079454
LBN Legal business name Thornblade, S Michelle
Credentials PA C
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 2nd, 2005
Last updated Jul 8th, 2007 - about 19 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 1629079454 NPPES
Colorado Other 1421 LICENSE (EXPIRED)
Colorado Other PA02088 LICENSE (EXPIRED)

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