Provider Demographics
NPI:1962437921
Name:KLANSEK, TERESA PINTER (DO)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:PINTER
Last Name:KLANSEK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:TERESA
Other - Middle Name:MICHELLE
Other - Last Name:PINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 758963
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-8963
Mailing Address - Country:US
Mailing Address - Phone:804-968-5700
Mailing Address - Fax:804-217-7991
Practice Address - Street 1:601 POTOMAC STATION DR NE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-1816
Practice Address - Country:US
Practice Address - Phone:703-804-1396
Practice Address - Fax:703-804-1397
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102037137207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00W411N07Medicare PIN
VAF27073Medicare UPIN
G02020N05Medicare PIN
VA257624YWAUMedicare PIN
VAVV8575BMedicare PIN