Provider Demographics
NPI:1265424782
Name:TURLA, MARIA THERESA (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:THERESA
Last Name:TURLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:M
Other - Middle Name:THERESA
Other - Last Name:TURLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-522-8603
Mailing Address - Fax:
Practice Address - Street 1:104 SIMPSON ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4413
Practice Address - Country:US
Practice Address - Phone:864-522-3900
Practice Address - Fax:864-522-3909
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC90351207W00000X
LA11727R207W00000X, 174400000X
MEMD23204207W00000X
VA0101269157207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1482242Medicaid
WI100178576Medicaid
LA27047OtherSTATE CDS
LA1482242Medicaid
5E318Medicare PIN