Basic Information
| Provider Information | |||||||||
| NPI: | 1124230750 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TEO | ||||||||
| FirstName: | ELROND | ||||||||
| MiddleName: | YI LANG | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.B., B.S, | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5132 WILLOW POINT PKWY | ||||||||
| Address2: | |||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300681755 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4046730519 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1968 PEACHTREE RD NW | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303091281 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8002433839 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2007 | ||||||||
| LastUpdateDate: | 03/24/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/06/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LC0200X | 069979 | GA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207L00000X | 069979 | GA | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.