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Organization
JOHN B. THEOBALDS & ASSOCIATE INC
Active
Organization
JOHN B. THEOBALDS & ASSOCIATE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN B THEOBALDS M.D. (PRESIDENT)
(202) 667-8701
Entity
Organization
Contact information
Practice address
3636 16TH ST NW, SUITE AG69, WASHINGTON, DC 20010-1146
(202) 667-8701
(202) 234-9218
Mailing address
3636 16TH ST NW, SUITE AG69, WASHINGTON, DC 20010-1146
(202) 667-8701
(202) 234-9218
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD11684
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
025405900
—
DC
05
—
777791400
—
MD
Enumeration date
07/13/2010
Last updated
07/13/2010
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