Individual
DR. MARK M THEISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3300
(703) 776-4001
(703) 776-7113
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
0101036798
VA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
0101036798
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006499317
—
VA
Enumeration date
12/16/2006
Last updated
01/29/2022
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