Individual
DR. MIRANDA THEODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
MASSACHUSETTS GENERAL HOSPITAL, 55 FRUIT ST., BOSTON, MA 02114
(617) 643-0596
Mailing address
MASSACHUSETTS GENERAL HOSPITAL, 55 FRUIT ST., BOSTON, MA 02114
(617) 643-0596
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
266944
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
277061
MA
207RP1001X
Pulmonary Disease Physician
Primary
277061
MA
Other
Enumeration date
05/10/2016
Last updated
04/25/2022
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