Provider Demographics
NPI:1710901871
Name:DIAZ-MONTES, TERESA (MD, MHS)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:DIAZ-MONTES
Suffix:
Gender:F
Credentials:MD, MHS
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:DE PILAR
Other - Last Name:DIAZ-MONTES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:227 ST. PAUL PLACE
Mailing Address - Street 2:6TH FLOOR
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202
Mailing Address - Country:US
Mailing Address - Phone:410-332-9200
Mailing Address - Fax:410-783-5880
Practice Address - Street 1:227 ST. PAUL PLACE
Practice Address - Street 2:6TH FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202
Practice Address - Country:US
Practice Address - Phone:410-332-9200
Practice Address - Fax:410-783-5880
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2013-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD61361207V00000X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD010537600Medicaid
MDH755O531Medicare PIN
MDH7550531Medicare UPIN