Thek, Kerry Diane
Thek, Kerry Diane is an individual health care provider with primary practice located at 1690 Dunlawton Ave Ste 120 , Port Orange FL 32127-8980. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as her primary health care specialty. Thek, Kerry Diane can be contacted via phone (386) 677-0531.Contact Information
Primary practice address
1690 Dunlawton Ave Ste 120
Port Orange FL 32127-8980
Phone: (386) 677-0531
Fax: (386) 673-4658
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | E-11212 | Arkansas |
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | ME58396 | Florida |
Profile Details
NPI number | 1457349417 |
---|---|
LBN Legal business name | Thek, Kerry Diane |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Oct 12th, 2005 |
Last updated | May 23rd, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1457349417 | NPPES |
Florida | MEDICAID | 064841800 |
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