Michael H Theodoulou

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

P0558 Issued in DC

Legal business name

MICHAEL H THEODOULOU

Practice address

3301 New Mexico Ave NW
Ste 221
Washington, DC 20016-3622

Phone

(202) 237-0038

Fax

(202) 237-2551

NPI assigned

Apr 29, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael H Theodoulou, DPM

Title

President

Phone

(202) 237-0038

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1780859892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 NEW MEXICO AVE NW",
            "address_2": "STE 221",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200163622",
            "telephone_number": "202-237-0038",
            "fax_number": "202-237-2551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 NEW MEXICO AVE NW",
            "address_2": "STE 221",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200163622",
            "telephone_number": "202-237-0038",
            "fax_number": "202-237-2551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL H THEODOULOU",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "THEODOULOU",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-237-0038",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "DC",
            "license": "P0558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020331900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tatiana Nigam Miandabo
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• Michael Chavis
• Unknown Michael Enya Enya
• Michael G. Golder, MD, PLLC
• Michael J. Grady M.D., P.C.
• Michael J. Petite MD PC
• Michael Lu
• Michael M Phillips M.D., P.C.
• Michael Mancilla Licsw

• Prosthetic/Orthotic Supplier in Washington, DC
• Providers in Washington, DC by specialty
• Prosthetic/Orthotic Supplier in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.