Provider Demographics
NPI:1285622084
Name:MENART, TERESA C (MD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:C
Last Name:MENART
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6255 CHAMBERSBURG RD
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-3858
Mailing Address - Country:US
Mailing Address - Phone:937-963-9505
Mailing Address - Fax:937-262-7303
Practice Address - Street 1:6255 CHAMBERSBURG RD
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-3858
Practice Address - Country:US
Practice Address - Phone:937-963-9505
Practice Address - Fax:937-262-7303
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.072192207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2084088Medicaid
F85843Medicare UPIN
F85843Medicare UPIN