Provider Demographics
NPI:1265588354
Name:TEUNIS, RALPH DEWEY III (OD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:DEWEY
Last Name:TEUNIS
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:5630 BRADLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1006
Mailing Address - Country:US
Mailing Address - Phone:301-654-6788
Mailing Address - Fax:301-652-3120
Practice Address - Street 1:5630 BRADLEY BLVD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1006
Practice Address - Country:US
Practice Address - Phone:301-654-6788
Practice Address - Fax:301-652-3120
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDTA1188152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU35364Medicare UPIN
MD127095Medicare PIN
MDP01215008Medicare PIN