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Individual

MICHAEL D TEAGUE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
907 E LAMAR ALEXANDER PARKWAY, MARYVILLE, TN 37804-5012
(865) 981-2335
(865) 694-4339
Mailing address
PO BOX 51883, KNOXVILLE, TN 37950-1883
(865) 766-8897
(865) 766-8874

Taxonomy

Speciality
Code
Description
License number
State
207ZC0500X
Cytopathology Physician
21749
TN
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
21749
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3826237
TN
Enumeration date
05/23/2006
Last updated
09/17/2012
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