Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. DAVID A THEODORO, M.D.
DeactivatedDR. DAVID A THEODORO, M.D. is a Thoracic Surgery (Cardiothoracic Vascular) healthcare provider located in BRIDGETON, Missouri. NPI 1073518577 is deactivated in the NPPES registry. Verify at CMS.
Thoracic Surgery (Cardiothoracic Vascular) · BRIDGETON, MO
This NPI has been deactivated.
The record was deactivated on March 20, 2006.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1073518577
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 20, 2005 (0.74794520547945 yrs)
- Last Updated
- Aug 27, 2020
- Deactivated
- Mar 20, 2006
- Licenses
-
118293 (MO)036095641 (IL)28104 (MS)
Practice Information
- Address
-
12255 DE PAUL DR NORTH BLDGSTE 260BRIDGETON, MO, 63044Browse MO providers · Browse ZIP 63044
- Phone
- 3146478269
- Fax
- 3146461700
- Primary Specialty
-
Thoracic Surgery (Cardiothoracic Vascular)
208G00000X
- Additional Specialty
- Thoracic Surgery (Cardiothoracic Vascular)
- Additional Specialty
- Thoracic Surgery (Cardiothoracic Vascular)
Other Thoracic Surgery (Cardiothoracic Vascular) Providers in BRIDGETON, MO
| Name | Credential | NPI |
|---|---|---|
| DR. PETER FONSECA | M.D. | 1760483101 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.