Individual
GREGOR STANLEY THEBAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
835 WASHINGTON ST, HUNTINGDON, PA 16652-1725
(814) 506-8114
(814) 506-8553
Mailing address
4133 MEDICAL CENTER DR, BROAD TOP, PA 16621-9001
(814) 635-2916
(814) 635-2918
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS016519
PA
207QS0010X
Sports Medicine (Family Medicine) Physician
OS016519
PA
Other
Enumeration date
08/08/2010
Last updated
06/06/2024
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