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Theodore J Southgate, MD
Cardiovascular Disease Physician in Newark, New Jersey
NPI 1730156217

Theodore J Southgate is a Cardiovascular Disease Physician based in Newark, NJ and is specialized in Cardiovascular Disease. Theodore J Southgate practices in Newark, NJ and has the professional credentials of MD. The NPI Number for Theodore J Southgate is 1730156217 and holds a License No. 25MA05005700 (New Jersey).

The current practice location address for Theodore J Southgate is 201 Lyons Ave, Newark, NJ and can be reached out via phone at 973-926-7749 and via fax at 973-923-4683.

Location: 201 Lyons Ave, Newark, NJ, 07112-2027
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1730156217
Provider Name
Theodore J Southgate
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
201 Lyons Ave, Newark, NJ, 07112-2027
Phone Number
973-926-7749
Fax Number
973-923-4683
Provider Enumeration Date
03/03/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7459106 05 NJ
institution
Provider Business Practice Location Address Details
Address
201 Lyons Ave
City
Newark
State
New Jersey
Zip
07112-2027
Phone Number
973-926-7749
Fax Number
973-923-4683
person
Provider Business Mailing Address Details
Address
201 Lyons Ave
City
Newark
State
New Jersey
Zip
07112-2027
Phone Number
973-926-7749
Fax Number
973-923-4683
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Cardiovascular Disease
Taxonomy
207RC0000X
License No.
25MA05005700 (New Jersey)
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
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