1437174935 NPI number — LOIS J TESTON MD

Table of content: LOIS J TESTON MD (NPI 1437174935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437174935 NPI number — LOIS J TESTON MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TESTON
Provider First Name:
LOIS
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

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:
1437174935
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
24701 EUCLID AVE
Provider Second Line Business Mailing Address:
3RD FLOOR
Provider Business Mailing Address City Name:
EUCLID
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44117-1714
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9485 MENTOR AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MENTOR
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44060-4597
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-205-5755
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/13/2006

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: 207RH0003X , with the licence number:  35073531 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2263901 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: TE4023262 . This identifiers is of the category "MEDICARE PIN".
  • Identifier: TE4023266 . This identifiers is of the category "MEDICARE PIN".
  • Identifier: 000000539218 . This is a "ANTHEM UHMG" identifier . This identifiers is of the category "OTHER".
  • Identifier: 739398 . This is a "BUCKEYE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000224424 . This is a "UNISON UHMG" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00432050 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: TE4023265 , issued by the state of ( OH ) . This identifiers is of the category "MEDICARE PIN".
  • Identifier: 000000373345 . This is a "ANTHEM 17" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00234179 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 364076 . This is a "WELLCARE 17" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7347111 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: H17401 , issued by the state of ( OH ) . This identifiers is of the category "MEDICARE UPIN".
  • Identifier: 000000192464 . This is a "UNISON 17" identifier . This identifiers is of the category "OTHER".