Provider Demographics
NPI:1568680189
Name:KURTZ, THERESA ANN (MD)
Entity Type:Individual
Prefix:
First Name:THERESA
Middle Name:ANN
Last Name:KURTZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:19020 BEALLSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BEALLSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20839-3302
Mailing Address - Country:US
Mailing Address - Phone:301-921-1012
Mailing Address - Fax:301-869-1480
Practice Address - Street 1:19020 BEALLSVILLE RD
Practice Address - Street 2:
Practice Address - City:BEALLSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20839-3302
Practice Address - Country:US
Practice Address - Phone:301-349-5799
Practice Address - Fax:301-349-5305
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD301622084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry