Provider Demographics
NPI:1821099730
Name:HANYOK, TERESA (MD)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:HANYOK
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 1:2973 MANCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:MD
Mailing Address - Zip Code:21102-1802
Mailing Address - Country:US
Mailing Address - Phone:410-374-4747
Mailing Address - Fax:443-507-0003
Practice Address - Street 1:2973 MANCHESTER RD
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:MD
Practice Address - Zip Code:21102-1802
Practice Address - Country:US
Practice Address - Phone:410-374-4747
Practice Address - Fax:443-507-0003
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0051816207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDF85497Medicare UPIN
MD024MMedicare ID - Type Unspecified