Individual
DOUGLAS WILLIAM TESKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-3100
(614) 722-2549
Mailing address
555 S 18TH ST, COLUMBUS, OH 43205-2654
(614) 722-3100
(614) 722-2549
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
35038174
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105638000
MEDICAID
WV
05
—
0296586
—
OH
01
—
64789084
MEDICAID
KY
Enumeration date
10/12/2005
Last updated
12/02/2008
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