Provider Demographics
NPI:1336514348
Name:TEO, GREG MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:GREG MATTHEW
Middle Name:
Last Name:TEO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0330
Practice Address - Street 1:1001 BRIGGS RD STE 250
Practice Address - Street 2:
Practice Address - City:MOUNT LAUREL
Practice Address - State:NJ
Practice Address - Zip Code:08054-4111
Practice Address - Country:US
Practice Address - Phone:856-206-4410
Practice Address - Fax:856-866-9088
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-02
Last Update Date:2021-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MA10830400207RI0200X, 207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty