Provider Demographics
NPI:1952492068
Name:DELAMERENS-PRATT, MARIA TERESA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARIA TERESA
Middle Name:
Last Name:DELAMERENS-PRATT
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 1:1255 S GERMANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-2227
Mailing Address - Country:US
Mailing Address - Phone:901-432-1591
Mailing Address - Fax:901-432-1596
Practice Address - Street 1:1255 S GERMANTOWN RD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-2227
Practice Address - Country:US
Practice Address - Phone:901-432-1591
Practice Address - Fax:901-432-1596
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18312208000000X, 2080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TND71863Medicare UPIN