Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Simon Daniel Xavier Thebault, MD

Individual provider Neurology Physician · NPI 1174258305

Dr. Simon Daniel Xavier Thebault, MD is a Neurology Physician in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2022.

Licensed in
PA
In the registry since
2022
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3400 Civic Center Blvd S 2nd Fl
Philadelphia, PA 19104
Phone: (215) 316-5151
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Neurology Physician (primary) Taxonomy 2084N0400X · Licence MD478091 (PA)

Record details

NPI number1174258305
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 21, 2022
Last updated in NPPESSeptember 28, 2022
Certification dateSeptember 28, 2022

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