Provider Demographics
NPI:1528125978
Name:UNDERWOOD, TERESA N (MD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:N
Last Name:UNDERWOOD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:TERESA-TRAM
Other - Middle Name:N
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:744 N. MARINE CORPS DRIVE
Mailing Address - Street 2:SUITE 121
Mailing Address - City:TAMUNING
Mailing Address - State:GUAM
Mailing Address - Zip Code:96913
Mailing Address - Country:UM
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:744 N. MARINE CORPS DRIVE
Practice Address - Street 2:SUITE 121
Practice Address - City:TAMUNING
Practice Address - State:GUAM
Practice Address - Zip Code:96913
Practice Address - Country:UM
Practice Address - Phone:671-588-2394
Practice Address - Fax:877-797-7025
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2022-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7418207V00000X
GUM-1808207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GUPENDINGOtherSELECTCARE
GUPENDINGMedicaid
GUPENDINGOtherNETCARE
GUPENDINGOtherSTAYWELL