Individual provider · Type 1 NPI

Simon Daniel Xavier Thebault, MD

Neurology Physician · Philadelphia, PA

NPI number 1174258305 Active

Practice location

3400 Civic Center Blvd S, 2nd Floor
Philadelphia, PA 19104

Call (215) 316-5151 Map

Mailing address

24 Cricket Ave, Apt 408
Ardmore, PA 19003

Specialties and licenses

TaxonomyCodeLicense
Neurology Physician Primary 2084N0400XMD478091 (PA)

Neurology Physician: A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

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About NPI 1174258305

Simon Daniel Xavier Thebault, MD's National Provider Identifier is 1174258305, issued on Jul 21, 2022. The primary taxonomy on file is Neurology Physician (2084N0400X), and the practice location is in Philadelphia, PA. The record was last updated on Sep 28, 2022.