Waller, Theodore

Waller, Theodore is an individual health care provider with primary practice located at 11140 Montgomery Rd , Cincinnati OH 45249-2309. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Waller, Theodore can be contacted via phone (513) 792-7800.

Contact Information

Primary practice address
11140 Montgomery Rd Cincinnati OH 45249-2309
Phone: (513) 792-7800
Fax: (513) 792-7807
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 35046812 Ohio
Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology 207RC0001X 35046812 Ohio

Profile Details

NPI number 1386609881
LBN Legal business name Waller, Theodore
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Oct 23rd, 2020 - about 4 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 1386609881 NPPES
Other 000000238182 ANTHEM MIDDLETOWN
MEDICAID 64860562 ANTHEM MIDDLETOWN
MEDICAID 0549464 ANTHEM MIDDLETOWN
Other 2520401 ANTHEM MIDDLETOWN
Other 0642403 ANTHEM MIDDLETOWN
MEDICAID 100335970 ANTHEM MIDDLETOWN
Other 000000019745 ANTHEM MIDDLETOWN

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