Individual
DR. WARREN STUART THEIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1405 ALICE ST, WAYCROSS, GA 31501-4528
(912) 285-8822
(912) 285-8898
Mailing address
1405 ALICE ST, WAYCROSS, GA 31501-4528
(912) 285-8822
(912) 285-8898
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
0101237160
VA
208D00000X
General Practice Physician
Primary
055345
GA
208D00000X
General Practice Physician
A84102
CA
208D00000X
General Practice Physician
ME96329
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
67269005A
—
GA
Enumeration date
09/02/2005
Last updated
06/03/2009
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