Individual
KRISTINE TEODORI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
02002441
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000721931
ANTHEM TRADITIONAL
IN
05
—
200492390
—
IN
Enumeration date
06/27/2005
Last updated
07/04/2021
Update your record
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