Individual
GEORGE H THEODORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
175 CAMBRIDGE ST, 4TH FLOOR, BOSTON, MA 02114-2743
(617) 724-7009
(617) 643-1006
Mailing address
PO BOX 86, HINGHAM, MA 02043-0086
(781) 749-9071
(781) 749-2133
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
150940
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3152502
—
MA
Enumeration date
08/12/2005
Last updated
03/27/2009
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