Theobald, Richard W
Theobald, Richard W is an individual health care provider with primary practice located at 5300 Memorial Dr , Two Rivers WI 54241-3923. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Theobald, Richard W can be contacted via phone (920) 793-7300.Contact Information
Primary practice address
5300 Memorial Dr
Two Rivers WI 54241-3923
Phone: (920) 793-7300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 25728 | Wisconsin |
Profile Details
| NPI number | 1952418063 |
|---|---|
| LBN Legal business name | Theobald, Richard W |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 24th, 2006 |
| Last updated | Jun 3rd, 2024 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1952418063 | NPPES |
| Wisconsin | MEDICAID | 30645900 |
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