Healthcare Provider Details

I. General information

NPI: 1750374682
Provider Name (Legal Business Name): ROBERT TECAU D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2005
Last Update Date: 03/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 MUMPER LN
DILLSBURG PA
17019-1395
US

IV. Provider business mailing address

205 GRANDVIEW AVE SUITE 210
CAMP HILL PA
17011-1708
US

V. Phone/Fax

Practice location:
  • Phone: 717-432-2411
  • Fax: 717-432-1409
Mailing address:
  • Phone: 717-972-4480
  • Fax: 717-972-4470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS002874L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: