Provider Demographics
NPI:1821322850
Name:THEORET, MARC ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:MARC
Middle Name:ROBERT
Last Name:THEORET
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 1:10 CENTER DR
Mailing Address - Street 2:BUILDING 10CRC, ROOM 3-3888
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20892-0001
Mailing Address - Country:US
Mailing Address - Phone:301-451-6955
Mailing Address - Fax:
Practice Address - Street 1:10 CENTER DR
Practice Address - Street 2:BUILDING 10CRC, ROOM 3-3888
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-451-6955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-23
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD63149207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology