Provider Demographics
NPI:1740218478
Name:TEEL, JOSEPH RYAN (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:RYAN
Last Name:TEEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:51 NORTH 39TH STREET
Mailing Address - Street 2:MUTCH BUILDING, 6TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-2640
Mailing Address - Country:US
Mailing Address - Phone:215-662-8777
Mailing Address - Fax:215-243-3290
Practice Address - Street 1:51 NORTH 39TH STREET
Practice Address - Street 2:7 FLOOR - MUTCH BLDG
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-2640
Practice Address - Country:US
Practice Address - Phone:215-662-8777
Practice Address - Fax:215-243-3290
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD439514207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102451433Medicaid
PA102451433Medicaid
VA010753J79Medicare PIN
PA187901Medicare PIN