Wilson, Teicha

Wilson, Teicha is an individual health care provider with primary practice located at 2111 College Dr Rehoboth Mckinley Christian Health Care Services, Gallup NM 87301-5600. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine. Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine is her primary health care specialty. Wilson, Teicha can be contacted via phone (505) 863-1820.

Contact Information

Primary practice address
2111 College Dr Rehoboth Mckinley Christian Health Care Services Gallup NM 87301-5600
Phone: (505) 863-1820
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD2004-0819 New Mexico
Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine 2080N0001X MD60027915 Washington

Profile Details

NPI number 1306818125
LBN Legal business name Wilson, Teicha
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 6th, 2006
Last updated Jan 28th, 2014 - about 12 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 1306818125 NPPES
Arizona MEDICAID 953126
Arizona Other NM009W12
Arizona Other QMYPR0068268
Arizona Other 202000082
Arizona Other 10019728
Arizona MEDICAID 42378516

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