Healthcare Provider Details

I. General information

NPI: 1912180472
Provider Name (Legal Business Name): CHRISTINA MOISIDIS-TESCH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2007
Last Update Date: 12/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SONNENBERGER STR 3
WIESBADEN HESSEN
65193
DE

IV. Provider business mailing address

SONNENBERGER STR 3
WIESBADEN HESSEN
65193
DE

V. Phone/Fax

Practice location:
  • Phone: 61-152-6887
  • Fax: 590710
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberHSF12706
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: