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Contact Information

GEORGE H. THEODORE, MD PC
175 CAMBRIDGE ST
4TH FLOOR
BOSTON, MA02114-2743
 Phone: 617-724-7009
 Fax: 617-643-1006
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Foot and Ankle Surgery

207XX0004X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for GEORGE H. THEODORE, MD PC

NPI Number 1215925888
LBN Legal business name GEORGE H. THEODORE, MD PC
Authorized official GEORGE THEODORE - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/07/2005
Last updated 10/14/2014 - About 12 years ago
Identifiers
MA License # 150940
MA Medicaid 9730290
MA Other M18225 BCBS MA
MA Other 173652 HPHC
MA Other 727867 TUFTS
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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