Individual
DR. THEODORE STEWART SEBASTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1800 TOWN CENTER DRIVE, STE 415, RESTON, VA 20190
(703) 709-1492
(703) 709-5111
Mailing address
1800 TOWN CENTER DRIVE, STE 415, RESTON, VA 20190
(703) 709-1492
(703) 709-5111
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
0101057014
VA
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
0101057014
VA
Other
Enumeration date
01/27/2006
Last updated
03/28/2018
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