Dr. Kerry Diane Thek
M.D. | Pediatric Gastroenterology | Female
Dr. Kerry Diane Thek, M.D. is a Port Orange, Florida based Pediatric doctor with medical specialization in
Pediatric Gastroenterology.
Current practice location of Dr. Kerry Diane Thek is
1690 Dunlawton Ave Ste 120, Port Orange, Florida - 32127-8980. She can be contacted on phone at
386-677-0531 and fax number 386-673-4658.
Dr. Kerry Diane Thek is a sole proprietor of her business.
NPI number (Unique professional ID) for Dr. Kerry Diane Thek is
1457349417 which was assigned by NPPES on 12 Oct, 2005 and it was last updated on 23 May, 2018.
Dr. Kerry Diane Thek license number is
ME58396 for Pediatrics Pediatric Gastroenterology (2080P0206X) in Florida.
Dr. Kerry Diane Thek specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
Complete Profile:
Dr. Kerry Diane Thek basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Pediatric Gastroenterology |
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| Provider Name : | Dr. Kerry Diane Thek |
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| Credential : | M.D. |
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| Gender : | Female |
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Business Address:
Dr. Kerry Diane Thek address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 1690 Dunlawton Ave Ste 120
Port Orange, FL, 32127-8980
United States |
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| Phone Number : | 386-677-0531 |
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| Fax Number : | 386-673-4658 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1457349417 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 12 Oct, 2005 |
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| Last Updated On : | 23 May, 2018 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dr. Kerry Diane Thek are as mentioned. Primary taxonomy code for Dr. Kerry Diane Thek, M.D. is
2080P0206X (Pediatrics Pediatric Gastroenterology).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080P0206X | Pediatrics Pediatric Gastroenterology | No | E-11212 | AR |
| 2080P0206X | Pediatrics Pediatric Gastroenterology | Yes | ME58396 | FL |
Legacy Identifiers:
Other legacy medical identifiers of Dr. Kerry Diane Thek such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
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| 064841800 | MEDICAID | FL | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 1690 Dunlawton Ave Ste 120
Port Orange, FL, 32127-8980
United States |
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| Phone Number : | 386-271-2273 |
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| Fax Number : | 386-271-2274 |
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Business Location:
Patients can refer following map for directions to
Dr. Kerry Diane Thek practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.