Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KERRY DIANE THEK, M.D.
ActiveDR. KERRY DIANE THEK, M.D. is a Pediatric Gastroenterology healthcare provider located in PORT ORANGE, Florida. NPI 1457349417 is currently active in the NPPES registry. Verify at CMS.
Pediatric Gastroenterology · PORT ORANGE, FL
Registration Details
- NPI Number
- 1457349417
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 12, 2005 (20.884359550396 yrs)
- Last Updated
- May 23, 2018
- Licenses
-
E-11212 (AR)ME58396 (FL)
Practice Information
- Address
-
1690 DUNLAWTON AVE STE 120PORT ORANGE, FL, 321278980Browse FL providers · Browse ZIP 32127
- Phone
- 3866770531
- Fax
- 3866734658
- Primary Specialty
-
Pediatric Gastroenterology
2080P0206X
- Additional Specialty
- Pediatric Gastroenterology
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.