Provider Demographics
NPI:1386818730
Name:SMITH DE CHERIF, TERESA KATHERINE ELAINE (MD, MIA)
Entity Type:Individual
Prefix:DR
First Name:TERESA
Middle Name:KATHERINE ELAINE
Last Name:SMITH DE CHERIF
Suffix:
Gender:F
Credentials:MD, MIA
Other - Prefix:MRS
Other - First Name:TERESA
Other - Middle Name:KATHERINE ELAINE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MASTER INT'L AFFAIRS
Mailing Address - Street 1:346 EL CERRO LOOP
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-7665
Mailing Address - Country:US
Mailing Address - Phone:786-942-1792
Mailing Address - Fax:
Practice Address - Street 1:13 MORA CLINIC RD
Practice Address - Street 2:BOX 209
Practice Address - City:MORA
Practice Address - State:NM
Practice Address - Zip Code:87732-2201
Practice Address - Country:US
Practice Address - Phone:575-387-2201
Practice Address - Fax:575-387-9149
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-16
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMPENDING207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease