Theodore, George H

Theodore, George H is an individual health care provider with primary practice located at 175 Cambridge St 4Th Floor, Boston MA 02114-2743. He recently has only one registered license in Allopathic & Osteopathic Physicians / Foot and Ankle Surgery, which is considered as his primary health care specialty. Theodore, George H can be contacted via phone (617) 724-7009.

Contact Information

Primary practice address
175 Cambridge St 4Th Floor Boston MA 02114-2743
Phone: (617) 724-7009
Fax: (617) 643-1006
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Foot and Ankle Surgery 207XX0004X 150940 Massachusetts

Profile Details

NPI number 1639171101
LBN Legal business name Theodore, George H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 12th, 2005
Last updated Mar 27th, 2009 - about 15 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 1639171101 NPPES
Massachusetts MEDICAID 3152502

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