Provider Demographics
NPI:1447602347
Name:WALLBRECHER, TOBIAS JAKOBUS (MD)
Entity Type:Individual
Prefix:MR
First Name:TOBIAS
Middle Name:JAKOBUS
Last Name:WALLBRECHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:VIA DOMENICO SILVERI 30
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:ITALY
Mailing Address - Zip Code:00165
Mailing Address - Country:IT
Mailing Address - Phone:003906-638-0569
Mailing Address - Fax:003906-639-0775
Practice Address - Street 1:VIA DOMENICO SILVERI 30
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:ITALY
Practice Address - Zip Code:00165
Practice Address - Country:IT
Practice Address - Phone:003906-638-0569
Practice Address - Fax:003906-639-0775
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-05
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT031400207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine