Provider Demographics
NPI:1043486251
Name:TODD B. TESCHER, M.D., PLLC
Entity Type:Organization
Organization Name:TODD B. TESCHER, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:TESCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-289-4600
Mailing Address - Street 1:8316 ARLINGTON BLVD
Mailing Address - Street 2:SUITE 514
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5207
Mailing Address - Country:US
Mailing Address - Phone:703-289-4600
Mailing Address - Fax:703-289-4601
Practice Address - Street 1:8316 ARLINGTON BLVD STE 414
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5216
Practice Address - Country:US
Practice Address - Phone:703-289-4600
Practice Address - Fax:703-289-4601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-07
Last Update Date:2018-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCG00718Medicare PIN