Individual
DR. NIHIL C THEODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8700 SUDLEY RD, MANASSAS, VA 20110-4418
(703) 396-5292
(703) 396-5297
Mailing address
PO BOX 748613, ATLANTA, GA 30384-8613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101238129
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10171679
—
VA
01
—
179071
ANTHEM BC/BS
VA
Enumeration date
08/03/2005
Last updated
02/24/2023
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