Provider Demographics
NPI:1528134004
Name:TENG, ERWEY ALBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ERWEY
Middle Name:ALBERT
Last Name:TENG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-7027
Mailing Address - Country:US
Mailing Address - Phone:207-795-0111
Mailing Address - Fax:207-795-2766
Practice Address - Street 1:76 HIGH ST
Practice Address - Street 2:SUITE 300
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-7649
Practice Address - Country:US
Practice Address - Phone:207-795-5544
Practice Address - Fax:207-795-5645
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD17809207RC0200X
ME017809207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30209376Medicaid
ME433283499Medicaid
ME433283499Medicaid
NH00175803Medicare PIN