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General NPI Number Information
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NPI Number | 1134148679
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Entity Type | Individual
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Provider Name | TERESA PIETRUS MD
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Gender | Female
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Dates
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Enumeration Date | 07/18/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8680 GRATIOT RD SUITE B
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City | SAGINAW
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State | MI
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Zip | 48609-4885
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Country | US
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Telephone | 989-781-3089
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Fax | 989-781-3209
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Provider Business Mailing Address
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Address Line | 4303 WINDEMERE DR
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City | SAGINAW
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State | MI
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Zip | 48603-1270
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Country | US
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Telephone | 989-249-0398
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | TP065998
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License Number State | MI
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