Provider Demographics
NPI:1336104884
Name:MORRELL RIECH, TERESA JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:JEAN
Last Name:MORRELL RIECH
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 1:5104 BIRD BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46268-5402
Mailing Address - Country:US
Mailing Address - Phone:317-293-2922
Mailing Address - Fax:
Practice Address - Street 1:5104 BIRD BRANCH DR
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-5402
Practice Address - Country:US
Practice Address - Phone:317-293-2922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01059317A207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics