S Michelle Thornblade, PA C

NPI #1629079454 in Waldorf, Maryland

Provider Information

NPI Number: 1629079454
Entity Type: Individual
Name: S Michelle Thornblade, PA C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA C
Enumeration Date: Aug 2, 2005
Last Updated: Jul 8, 2007

Practice Location

Address: 3975 SAINT CHARLES PKWY
City: Waldorf
State: Maryland
ZIP Code: 20602-2683
Phone: (301) 645-6800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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