Provider Demographics
NPI:1669498028
Name:TESCHER, TODD BRIAN (MD)
Entity type:Individual
Prefix:DR
First Name:TODD
Middle Name:BRIAN
Last Name:TESCHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8316 ARLINGTON BLVD STE 414
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-5216
Mailing Address - Country:US
Mailing Address - Phone:703-289-4600
Mailing Address - Fax:703-289-4601
Practice Address - Street 1:8316 ARLINGTON BLVD STE 414
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-5216
Practice Address - Country:US
Practice Address - Phone:703-289-4600
Practice Address - Fax:703-289-4601
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057553208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA007504250Medicaid
VA00A895T18Medicare PIN
VA007504250Medicaid
P00364771Medicare PIN