| Doctor Name: | MR. BENJAMIN THIEL |
| NPI Number: | 1689982043 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN |
| License Number: | 17073430 |
| Business Practice Address: | W147s6942 Durham Pl Muskego, WI - 531503138 |
| Business Phone Number: | 4147362932 |
| Business Fax Number: | |
| Mailing Address: | W147s6942 Durham Pl, MUSKEGO |
| State: | WI |
| Postal Code: | 531503138 |
| Phone Number: | 4147362932 |
| Fax Number: | |
| NPI Enumeration Date: | 09/20/2010 |
| NPI Last Update Date: | 09/20/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0200X |
| License Number: | 17073430 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Critical Care Medicine |
| Taxonomy Definition: | |