Healthcare Provider Details

I. General information

NPI: 1215915418
Provider Name (Legal Business Name): TERRI H. GREEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TERRI H. LUNSFORD M.D.

II. Dates (important events)

Enumeration Date: 01/06/2006
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E EAGER ST
BALTIMORE MD
21202-5533
US

IV. Provider business mailing address

1000 E EAGER ST
BALTIMORE MD
21202-5533
US

V. Phone/Fax

Practice location:
  • Phone: 410-522-9800
  • Fax:
Mailing address:
  • Phone: 410-522-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD32735
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberD0058877
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: