Individual
DR. ELEANOR THERESA TEDESCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3922 GLENMERE DR, MYRTLE BEACH, SC 29588-6769
(508) 769-2364
(843) 668-2468
Mailing address
3922 GLENMERE DR, MYRTLE BEACH, SC 29588-6769
(508) 769-2364
(843) 668-2468
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
152283
MA
2084P0800X
Psychiatry Physician
Primary
87398
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3178111
—
MA
Enumeration date
01/23/2007
Last updated
03/01/2024
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