Provider Demographics
NPI:1891851713
Name:FUCHS, THERESE (MD)
Entity Type:Individual
Prefix:
First Name:THERESE
Middle Name:
Last Name:FUCHS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:THERESE
Other - Middle Name:
Other - Last Name:TORDJMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:POST OFFICE BOX 3
Mailing Address - Street 2:
Mailing Address - City:BNEI-BRAQ
Mailing Address - State:IL
Mailing Address - Zip Code:51200
Mailing Address - Country:IL
Mailing Address - Phone:617-600-3990
Mailing Address - Fax:
Practice Address - Street 1:227 RAINBOW DR
Practice Address - Street 2:SUITE 12704
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77399-0001
Practice Address - Country:US
Practice Address - Phone:617-600-3990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA58847207RC0001X
ND15961207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology