Provider Demographics
NPI:1558391235
Name:VOORSTAD, THEODOOR ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:THEODOOR
Middle Name:ANTHONY
Last Name:VOORSTAD
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 1:2550 KINGSTON RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-3735
Mailing Address - Country:US
Mailing Address - Phone:717-840-4646
Mailing Address - Fax:
Practice Address - Street 1:2550 KINGSTON RD
Practice Address - Street 2:SUITE 205
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-3735
Practice Address - Country:US
Practice Address - Phone:717-840-4646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2010-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD060494L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA100493OtherGEISINGER
PA7798492OtherAETNA
PA32653OtherJOHNS HOPKINS
PA590875OtherHIGHMARK BLUE SHIELD
PA1146401OtherAMERIHEALTH MERCY-YH
PA298033OtherMAMSI-YH
PA80832OtherUNISON-YH
PA03126701OtherCAPITAL BLUE CROSS-YH
PA110234441OtherRAILROAD MEDICARE
MD614039OtherCAREFIRST MD BCBS
PA001857610Medicaid
PAP004684OtherGATEWAY-YH
PA590875OtherHIGHMARK BLUE SHIELD
G41919Medicare UPIN