Individual
DR. MARY C. THEROUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
A.I. DUPONT HOSPITAL FOR CHILDREN, 1600 ROCKLAND ROAD, WILMINGTON, DE 19803-3607
(302) 651-4000
(302) 651-4945
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
C10003285
DE
207LP3000X
Pediatric Anesthesiology Physician
Primary
C10003285
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001217513
—
PA
05
—
1437865
—
NY
05
—
5032407
—
NJ
05
—
5747473
—
VA
05
—
7613677
—
NC
05
—
7742614
—
MD
05
—
Q03285
—
SC
Enumeration date
12/11/2006
Last updated
09/03/2011
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