Provider Demographics
NPI:1245755255
Name:TEO, HONEYLEN MARYL TIU (MD)
Entity Type:Individual
Prefix:
First Name:HONEYLEN MARYL
Middle Name:TIU
Last Name:TEO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1109 MAIDEN LANE CT APT 102
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-1928
Mailing Address - Country:US
Mailing Address - Phone:734-763-9147
Mailing Address - Fax:
Practice Address - Street 1:1000 WALL ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-1912
Practice Address - Country:US
Practice Address - Phone:734-604-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301112297207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology