1447602347 NPI number — MR. TOBIAS JAKOBUS WALLBRECHER M.D.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447602347 NPI number — MR. TOBIAS JAKOBUS WALLBRECHER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALLBRECHER
Provider First Name:
TOBIAS
Provider Middle Name:
JAKOBUS
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447602347
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/05/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
VIA DOMENICO SILVERI 30
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROME
Provider Business Mailing Address State Name:
ITALY
Provider Business Mailing Address Postal Code:
00165
Provider Business Mailing Address Country Code:
IT
Provider Business Mailing Address Telephone Number:
0039066380569
Provider Business Mailing Address Fax Number:
0039066390775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VIA DOMENICO SILVERI 30
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROME
Provider Business Practice Location Address State Name:
ITALY
Provider Business Practice Location Address Postal Code:
00165
Provider Business Practice Location Address Country Code:
IT
Provider Business Practice Location Address Telephone Number:
0039066380569
Provider Business Practice Location Address Fax Number:
0039066390775
Provider Enumeration Date:
07/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  031400 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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