Individual
DAVID P THIBODEAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
827 ROCKVILLE PIKE STE F, ROCKVILLE, MD 20852-1267
(301) 251-2777
(240) 766-0304
Mailing address
11418 LIVINGSTON RD, FT WASHINGTON, MD 20744-5145
(240) 766-0300
(240) 766-0304
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
142104
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KB80
BLUE CROSS BLUE OF MD
MD
01
—
S825
BLUE CROSS BLUE SHIELD
DC
Enumeration date
09/27/2007
Last updated
09/27/2007
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