Deweese, Theodore Leslie

Deweese, Theodore Leslie is an individual health care provider with primary practice located at 600 N Wolfe St , Baltimore MD 21287-0005. He recently has only one registered license in Allopathic & Osteopathic Physicians / Radiation Oncology, which is considered as his primary health care specialty. Deweese, Theodore Leslie can be contacted via phone (410) 955-8964.

Contact Information

Primary practice address
600 N Wolfe St Baltimore MD 21287-0005
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X D47485 Maryland
Allopathic & Osteopathic Physicians / Radiation Oncology 2085R0001X D14152 Maryland

Profile Details

NPI number 1528003373
LBN Legal business name Deweese, Theodore Leslie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 17th, 2006
Last updated Jan 17th, 2014 - about 11 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 1528003373 NPPES
Maryland MEDICAID 376561000

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