Provider Demographics
NPI:1326312091
Name:REISS, THEODORE FELD (MD)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:FELD
Last Name:REISS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1161 21ST AVE SOUTH T-1218 MEDICAL CENTER NORTH
Mailing Address - Street 2:VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-2650
Mailing Address - Country:US
Mailing Address - Phone:615-322-3773
Mailing Address - Fax:615-343-7448
Practice Address - Street 1:1161 21ST AVE SOUTH T-1218 MEDICAL CENTER NORTH
Practice Address - Street 2:VANDERBILT UNIVERSITY SCHOOL OF MEDICINE
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-2650
Practice Address - Country:US
Practice Address - Phone:615-322-3773
Practice Address - Fax:615-343-7448
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-28
Last Update Date:2012-02-28
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Provider Licenses
StateLicense IDTaxonomies
TN48119207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease