Organization
MARK M. THEISS, MD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDREY CARR (OFFICE MANAGER)
(703) 573-2218
Entity
Organization
Contact information
Practice address
8316 ARLINGTON BLVD, SUITE 414, FAIRFAX, VA 22031-5207
(703) 573-2218
(703) 573-2373
Mailing address
8316 ARLINGTON BLVD, SUITE 414, FAIRFAX, VA 22031-5207
(703) 573-2218
(703) 573-2373
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101036798
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TH475892
—
VA
Enumeration date
08/26/2009
Last updated
08/26/2009
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