Individual
TERESA M. LO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20 GLENLAKE PKWY, ATLANTA, GA 30328-3473
(770) 677-6137
Mailing address
20 GLENLAKE PKWY, ATLANTA, GA 30328-3473
(770) 677-6137
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
59460
GA
207Y00000X
Otolaryngology Physician
ME92622
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
59460
LICENSE
GA
01
—
ME92622
MEDICAL LICENSE
FL
Enumeration date
10/12/2006
Last updated
01/13/2022
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