Provider Demographics
NPI:1326073834
Name:GEORGE A TEEKAH, MD, DC
Entity Type:Organization
Organization Name:GEORGE A TEEKAH, MD, DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TEEKAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-788-0556
Mailing Address - Street 1:PO BOX 26178
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23260-6178
Mailing Address - Country:US
Mailing Address - Phone:804-788-0556
Mailing Address - Fax:804-788-1141
Practice Address - Street 1:505 W LEIGH ST
Practice Address - Street 2:STE 207
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23220-3200
Practice Address - Country:US
Practice Address - Phone:804-788-0556
Practice Address - Fax:804-788-1141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-12
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004301OtherANTHEM BS
VA6047939Medicaid
VA004301OtherANTHEM BS