Individual
THEODORE J PATSOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
91 WATER ST, MILFORD, MA 01757-3039
(508) 458-4250
(508) 458-4251
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
54640
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110044118A
—
MA
01
—
J05312
BCBS
—
Enumeration date
08/23/2006
Last updated
11/05/2020
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