Hodge, Theo Wallace

Hodge, Theo Wallace is an individual health care provider with primary practice located at 1140 Varnum St Ne , Washington DC 20017-2151. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Infectious Disease. Allopathic & Osteopathic Physicians / Infectious Disease is his primary health care specialty. Hodge, Theo Wallace can be contacted via phone (405) 220-2854.

Contact Information

Primary practice address
1140 Varnum St Ne Washington DC 20017-2151
Phone: (405) 220-2854
Fax: (202) 854-4832
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X MD18133 District of Columbia
Allopathic & Osteopathic Physicians / Infectious Disease 207RI0200X MD18133 District of Columbia

Profile Details

NPI number 1912007725
LBN Legal business name Hodge, Theo Wallace
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated May 17th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912007725 NPPES
District of Columbia Other G22464 UPIN

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