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Individual

DR. THEODORE CARLTON BROOKS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
341 BEAVER ST, SEWICKLEY, PA 15143-1438
(304) 639-6753
Mailing address
341 BEAVER ST, SEWICKLEY, PA 15143-1438
(304) 639-6753

Taxonomy

Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
194723
NY
207ZP0101X
Anatomic Pathology Physician
39871
WI
208D00000X
General Practice Physician
194723-1
NY

Other

Enumeration date
10/08/2010
Last updated
11/06/2017
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