Provider Demographics
NPI:1922015205
Name:TEITEL, STEVEN ERIC (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:ERIC
Last Name:TEITEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WILLIAM CARLS DR
Mailing Address - Street 2:RSC SUITE
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-2201
Mailing Address - Country:US
Mailing Address - Phone:248-937-3451
Mailing Address - Fax:248-937-5128
Practice Address - Street 1:44000 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48377
Practice Address - Country:US
Practice Address - Phone:248-937-3451
Practice Address - Fax:248-937-5128
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301406618207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIOF37093Medicare ID - Type Unspecified
MIE49679Medicare UPIN