Individual
DR. MYRA LYNN TEASLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4414 LAKE BOONE TRL, SUITE 300, RALEIGH, NC 27607-7513
(919) 781-5510
(919) 781-5053
Mailing address
7628 RAINWATER RD, RALEIGH, NC 27615-3745
(919) 781-5510
(919) 781-5053
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
32181
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32716
PARTNERS
NC
01
—
750598
UNITED HEALTHCARE
NC
01
—
82346
BC/BS
NC
05
—
8982346
—
NC
Enumeration date
03/27/2006
Last updated
03/30/2015
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