Provider Demographics
NPI:1427024892
Name:TETER, JAMES L (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:TETER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13420 N MERIDIAN ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-1580
Mailing Address - Country:US
Mailing Address - Phone:317-573-7050
Mailing Address - Fax:317-573-7098
Practice Address - Street 1:13420 N MERIDIAN ST
Practice Address - Street 2:SUITE 400
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-1580
Practice Address - Country:US
Practice Address - Phone:317-573-7050
Practice Address - Fax:317-573-7098
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2016-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01026384A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100381700Medicaid
IN677690IIMedicare PIN
IND94582Medicare UPIN
IN160020851Medicare PIN