Provider Demographics
NPI:1972520849
Name:PODREBARAC, THERESA ANNE (MD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:ANNE
Last Name:PODREBARAC
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:111 CYPRESS ST
Mailing Address - Street 2:BRIGHAM AND WOMENS PHYSICIANS ORGANIZATION
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445
Mailing Address - Country:US
Mailing Address - Phone:617-582-1200
Mailing Address - Fax:
Practice Address - Street 1:245 FIRST ST 16TH FLOOR
Practice Address - Street 2:COMBINATORX INC
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02142
Practice Address - Country:US
Practice Address - Phone:617-301-7076
Practice Address - Fax:617-301-7030
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA151190207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology