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General NPI Number Information
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NPI Number | 1326007238
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Entity Type | Individual
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Provider Name | BRUCE TEICH MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 06/29/2021
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Provider Practice Location Address
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Address Line | 500 W BERKELEY ST
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City | UNIONTOWN
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State | PA
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Zip | 15401-5514
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Country | US
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Telephone | 724-430-5108
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Fax | 724-430-3382
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Provider Business Mailing Address
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Address Line | 500 W BERKELEY ST
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City | UNIONTOWN
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State | PA
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Zip | 15401-5514
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Country | US
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Telephone | 724-430-5108
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Fax | 724-430-3382
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | MD040114E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 51774
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License Number State | AZ
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