Basic Information
| Provider Information | |||||||||
| NPI: | 1558328930 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TEBROCK | ||||||||
| FirstName: | CHRISTOPHER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2101 E JEFFERSON ST | ||||||||
| Address2: | |||||||||
| City: | ROCKVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208524908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002276472 | ||||||||
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| Practice Location | |||||||||
| Address1: | LANDSTUL REGIONAL MEDICAL CENTER | ||||||||
| Address2: | ANESTHESIA | ||||||||
| City: | APO | ||||||||
| State: | AE | ||||||||
| PostalCode: | 09180 | ||||||||
| CountryCode: | DE | ||||||||
| TelephoneNumber: | 011496371868109 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/28/2006 | ||||||||
| LastUpdateDate: | 05/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 01051935 | IN | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.