Individual
DR. VICTOR MANUEL TEJADA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 CARBONTON RD, SANFORD, NC 27330-4009
(919) 774-6521
(919) 776-6179
Mailing address
284 EXECUTIVE PARK DR STE 100, CONCORD, NC 28025-1833
(704) 939-1100
(704) 939-1173
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
28907
NC
2084P0804X
Child & Adolescent Psychiatry Physician
28907
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578763686
HUMANA
NC
05
—
1578763686
—
NC
01
—
170407-000
MAGELLAN
NC
01
—
82334
BCBS
NC
Enumeration date
07/18/2007
Last updated
10/12/2017
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