Basic Information
Provider Information
NPI: 1467507350
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TETTE
FirstName: AMADEA
MiddleName: R
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 EAST JEFFERSON STREET
Address2: KAISER PERMANENTE, PPQA, 6 WEST
City: ROCKVILLE
State: MD
PostalCode: 20852
CountryCode: US
TelephoneNumber: 3018166660
FaxNumber: 3018166308
Practice Location
Address1: 10810 CONNECTICUT AVENUE
Address2:  
City: KENSINGTON
State: MD
PostalCode: 20895
CountryCode: US
TelephoneNumber: 3019297100
FaxNumber: 3019297114
Other Information
ProviderEnumerationDate: 01/24/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XD0036480MDY Allopathic & Osteopathic PhysiciansSurgery 
208600000X0101043554VAN Allopathic & Osteopathic PhysiciansSurgery 
208600000XMD15356DCN Allopathic & Osteopathic PhysiciansSurgery 

No ID Information.


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