Provider Demographics
NPI:1609077106
Name:COLTERELLI, THEODORE JAMES III (DO)
Entity Type:Individual
Prefix:DR
First Name:THEODORE
Middle Name:JAMES
Last Name:COLTERELLI
Suffix:III
Gender:M
Credentials:DO
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Mailing Address - Street 1:2901 JOLLY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH MEETING
Mailing Address - State:PA
Mailing Address - Zip Code:19462-2324
Mailing Address - Country:US
Mailing Address - Phone:610-272-8221
Mailing Address - Fax:610-272-5655
Practice Address - Street 1:2901 JOLLY RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH MEETING
Practice Address - State:PA
Practice Address - Zip Code:19462-2324
Practice Address - Country:US
Practice Address - Phone:610-272-8221
Practice Address - Fax:610-272-5655
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2022-05-10
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Provider Licenses
StateLicense IDTaxonomies
PAOS014368208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice