Provider Demographics
NPI:1346251964
Name:TEE, RICHARD HARRY (CRNA)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:HARRY
Last Name:TEE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 707
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:NC
Mailing Address - Zip Code:27962-0707
Mailing Address - Country:US
Mailing Address - Phone:252-793-4135
Mailing Address - Fax:252-793-7740
Practice Address - Street 1:958 U.S. HWY 64 EAST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:NC
Practice Address - Zip Code:27962-9216
Practice Address - Country:US
Practice Address - Phone:252-793-4135
Practice Address - Fax:252-793-7740
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC023260367500000X
NC47279367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8050918Medicaid
NC8050918Medicaid
NC430074610Medicare PIN
NC260268EMedicare PIN