Mendoza, Teresa M

Mendoza, Teresa M is an individual health care provider with primary practice located at 1700 Tuttle St , Baraboo WI 53913-3319. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mendoza, Teresa M can be contacted via phone (608) 355-3800.

Contact Information

Primary practice address
1700 Tuttle St Baraboo WI 53913-3319
Phone: (608) 355-3800
Fax: (608) 355-7001
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 37504-020 Wisconsin

Profile Details

NPI number 1669438651
LBN Legal business name Mendoza, Teresa M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated May 5th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669438651 NPPES
Wisconsin Other 1000254 PHYSICIANS PLUS
Wisconsin Other 5619 PHYSICIANS PLUS
Wisconsin MEDICAID 32205200 PHYSICIANS PLUS

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