Peter C Theut in Grand Rapids - Sports Medicine
Peter C Theut - NPI 1720076219
Peter C Theut is a Sports Medicine in Grand Rapids, Michigan. Peter C Theut practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Peter C Theut is 1720076219. The last update date is 2013-03-12.
Peter C Theut's current location address is 1111 Leffingwell Ave Ne, Grand Rapids, Michigan. You can contact this provider via phone number 6164597101. The mailing address for Peter C Theut is 1111 Leffingwell Ave Ne, Grand Rapids, Michigan. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Peter C Theut |
|---|---|
| Address | 1111 Leffingwell Ave Ne, Grand Rapids, Michigan |
| Phone Number | 6164597101 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1720076219 |
|---|---|
| Provider Enumeration Date | 2005-10-10 |
| Last Updated Date | 2013-03-12 |
Provider Mailing Address Detail
| Address | 1111 Leffingwell Ave Ne |
|---|---|
| City | Grand Rapids |
| State | Michigan (MI) |
| Post Code | 495256406 |
| Phone Number | 6164597101 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 207Xx0005X |
| Licence No | 4301063761 |
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Definition: An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, train |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4216995 | MI | -- |
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What is the unique provider identifier assigned to Peter C Theut?
The Peter C Theut has been issued the NPI (National Provider Identifier) 1720076219 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Where is the Peter C Theut located?
The Peter C Theut is located at 1111 Leffingwell Ave Ne, Grand Rapids, MI 495256406.
What is Peter C Theut's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Peter C Theut is Sports Medicine, and the taxonomy classification code that categorizes this area of expertise is 207Xx0005X.
When did Peter C Theut receive its 1720076219 assignment?
The Peter C Theut was assigned its 1720076219 on 2005-10-10, which is the date when this unique identifier was issued to the organization.
When was the information pertaining to Peter C Theut most recently updated or revised?
The details related to Peter C Theut, including its address, specialty, and other relevant information, were last updated or revised on 2013-03-12.
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