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Individual

CHARLES MARK TETER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4720 S HARVARD AVE, 100, TULSA, OK 74135
(918) 749-6730
(918) 403-6318
Mailing address
4720 S HARVARD AVE, 100, TULSA, OK 74135-3048
(918) 749-6730
(918) 403-6318

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
13821
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100101410A
OK
Enumeration date
06/08/2006
Last updated
07/18/2018
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