Provider Demographics
NPI:1073554713
Name:CAMDEN, TERESA MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:MARIA
Last Name:CAMDEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TERESA
Other - Middle Name:SIBENI
Other - Last Name:STADLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, FACSM
Mailing Address - Street 1:5252 LYNGATE CT
Mailing Address - Street 2:203
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-1672
Mailing Address - Country:US
Mailing Address - Phone:703-239-2300
Mailing Address - Fax:703-239-2301
Practice Address - Street 1:5211 W BROAD ST
Practice Address - Street 2:101
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3009
Practice Address - Country:US
Practice Address - Phone:804-288-3025
Practice Address - Fax:804-288-3029
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101238212207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA540885859OtherC&O EMPLOYEE'S HEALTHCARE
VAP00281047OtherRAILROAD MEDICARE
VA540885859OtherFIRST HEALTH/CCN
VA10003094OtherOPTIMA HEALTH
VA185138OtherANTHEM HEALTHKEEPERS
VA540885859OtherCIGNA
VA540885859OtherCORVEL
VA7575263OtherAETNA HMO
VA0472640005OtherDMERC
VA540885859OtherCOMPMANAGEMENT
VA540885859OtherPRIVATE HEALTHCARE SYSTEM
VA540885859OtherFOCUS
VA010223849Medicaid
VA61270OtherSH CARENET
VA185138OtherANTHEM HEALTHKEEPERS
VA540885859OtherCIGNA