Provider Demographics
NPI:1861466674
Name:GUILBERT, THERESA W (MD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:W
Last Name:GUILBERT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 2021
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-803-0493
Mailing Address - Fax:513-636-4615
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 2021
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3026
Practice Address - Country:US
Practice Address - Phone:513-803-0493
Practice Address - Fax:513-636-4615
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1225022080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology