Basic Information
Provider Information
NPI: 1821017104
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THORPE
FirstName: MICHAEL
MiddleName: ALAN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2979 SQUALICUM PKWY
Address2: SUITE #203
City: BELLINGHAM
State: WA
PostalCode: 982251811
CountryCode: US
TelephoneNumber: 3607337670
FaxNumber: 3606471901
Practice Location
Address1: 2979 SQUALICUM PKWY
Address2: SUITE #203
City: BELLINGHAM
State: WA
PostalCode: 982251811
CountryCode: US
TelephoneNumber: 3607337670
FaxNumber: 3606471901
Other Information
ProviderEnumerationDate: 07/18/2006
LastUpdateDate: 09/12/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000XMD00022602WAY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 
207XX0005XMD00022602WAN Allopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine

No ID Information.


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