Healthcare Provider Details

I. General information

NPI: 1124224423
Provider Name (Legal Business Name): TERESA BERNADETTE FINKE-MORELAND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERESA BERNADETTE FINKE MD

II. Dates (important events)

Enumeration Date: 06/23/2007
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CHESTNUT ST STE 303
LOUISVILLE KY
40202-1831
US

IV. Provider business mailing address

PO BOX 776351
CHICAGO IL
60677-6351
US

V. Phone/Fax

Practice location:
  • Phone: 502-629-5552
  • Fax: 502-629-3132
Mailing address:
  • Phone: 502-588-9490
  • Fax: 502-272-5116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.090267
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35.090267
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RA0000X
TaxonomyAdolescent Medicine (Internal Medicine) Physician
License Number35058
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number56393
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: