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Individual

CAROL I TEITLEBAUM

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
2121 HUGHES DR, SUITE 300, TOLEDO, OH 43606-3845
(419) 291-2121
(419) 479-6017
Mailing address
2121 HUGHES DR, SUITE 300, TOLEDO, OH 43606-3845
(419) 291-2121
(419) 479-6017

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35033744
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000141216
ANTHEM
OH
01
000000251089
ANTHEM
MI
01
01173
PHC
OH
01
0308296
BCMH
OH
05
0308296
OH
01
0635403
AETNA
OH
01
10724
HPM
OH
01
12-03672
UHC
MI
01
12-20678
UHC
OH
01
4263159
AETNA
MI
Enumeration date
08/25/2005
Last updated
07/08/2007
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