Provider Demographics
NPI:1083095186
Name:TEICHMEIER, TYLER RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:RYAN
Last Name:TEICHMEIER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5440 SOUTH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-2116
Mailing Address - Country:US
Mailing Address - Phone:402-465-1900
Mailing Address - Fax:
Practice Address - Street 1:5440 SOUTH ST STE 200
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68506-2116
Practice Address - Country:US
Practice Address - Phone:402-465-1900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-15
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE31303207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE7463OtherTEMPORARY EDUCATIONAL PERMIT