Individual
MATEI TEODORESCU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
425 7TH ST NW, CASS LAKE, MN 56633-3360
(218) 335-3200
Mailing address
425 7TH ST NW, CASS LAKE, MN 56633-3360
(218) 335-3200
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
44112
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12-02485
MEDICA
MN
05
—
141035
—
MN
01
—
1415252
ARAZ
MN
01
—
46G55TE
BCBS
MN
05
—
46G55TE
—
MN
05
—
544668
—
IA
05
—
71613800
—
MN
01
—
7309
AVERA
MN
01
—
A044
CHAMPUS
MN
01
—
HP33897
HEALTH PARTNERS
MN
01
—
MH9041028422
PPO
MN
Enumeration date
12/01/2005
Last updated
05/28/2013
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