Individual
DR. DOUGLAS W TELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2115 LEITER RD, MIAMISBURG, OH 45342-3600
(937) 384-6800
(937) 384-6939
Mailing address
2115 LEITER RD, MIAMISBURG, OH 45342-3600
(937) 384-6800
(937) 384-6939
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35048745
OH
207RA0000X
Adolescent Medicine (Internal Medicine) Physician
35048745
OH
207RA0401X
Addiction Medicine (Internal Medicine) Physician
35048745
OH
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
35048745
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000330888
ANTHEM
—
01
—
016801000
MAGELLAN
—
05
—
0664311
—
OH
Enumeration date
11/14/2005
Last updated
11/18/2020
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