# DR. WARREN STUART THEIS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1588658702
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | 0101237160 | VA | — |
| 208D00000X | General Practice Physician | 055345 | GA | Yes |
| 208D00000X | General Practice Physician | A84102 | CA | — |
| 208D00000X | General Practice Physician | ME96329 | FL | — |

## Other

- **Enumeration date:** 09/02/2005
- **Last updated:** 06/03/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 67269005A | — | GA |