Provider Demographics
NPI:1437174935
Name:TESTON, LOIS J (MD)
Entity Type:Individual
Prefix:
First Name:LOIS
Middle Name:J
Last Name:TESTON
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 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5133 RIDGE RD STE 5
Practice Address - Street 2:
Practice Address - City:WADSWORTH
Practice Address - State:OH
Practice Address - Zip Code:44281-8078
Practice Address - Country:US
Practice Address - Phone:330-239-7250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35073531207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2263901Medicaid
OHP00432050OtherRAILROAD MEDICARE
000000539218OtherANTHEM UHMG
7347111OtherAETNA
OHP00234179OtherRAILROAD MEDICARE
364076OtherWELLCARE 17
739398OtherBUCKEYE
000000224424OtherUNISON UHMG
000000192464OtherUNISON 17
000000373345OtherANTHEM 17
364076OtherWELLCARE 17
7347111OtherAETNA
OHH17401Medicare UPIN
000000192464OtherUNISON 17