MEDICARE: DR. GARY WILLIAM TERLE PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	15363	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	4351168	OTHER	AETNA (HMO)
2	928187	OTHER	FIRST HEALTH
3	425730	OTHER	BCBS OF MARYLAND

General Provider Information

NPI Number	:	1881692168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY WILLIAM TERLE PT

Provider Business Mailing Address
First Line	:	5480 WISCONSIN AVE
Second Line	:	SUITE B-1
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3530
Country	:	US
Telephone Number	:	301-654-7383
Fax Number	:	301-654-7897

Provider Business Practice Location Address
First Line	:	5480 WISCONSIN AVE
Second Line	:	SUITE B-1
City	:	CHEVY CHASE
State	:	MD
Zip	:	20815-3530
Country	:	US
Telephone Number	:	301-654-7383
Fax Number	:	301-654-7897

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/12/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. GARY WILLIAM TERLE PT” Practice Location

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