Provider Demographics
NPI:1144216060
Name:BRIONES-RAMILO, TERESITA (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESITA
Middle Name:
Last Name:BRIONES-RAMILO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:TERESITA
Other - Middle Name:
Other - Last Name:BRIONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:6642 KING JOHN CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-7306
Mailing Address - Country:US
Mailing Address - Phone:317-431-3158
Mailing Address - Fax:
Practice Address - Street 1:6642 KING JOHN CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46227-7306
Practice Address - Country:US
Practice Address - Phone:317-431-3158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-26
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01034652A2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100115020AMedicaid
IN677340KMedicare ID - Type Unspecified
IN100115020AMedicaid