Individual
LUIS A TELLEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3371 KEMP RD, BEAVERCREEK, OH 45431-2514
(937) 320-3500
Mailing address
26700 BROOKPARK ROAD EXT # 1, NORTH OLMSTED, OH 44070-3124
(440) 716-0800
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35-07-3444T
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2218068
—
OH
Enumeration date
07/10/2006
Last updated
10/08/2020
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