Healthcare Provider Details

I. General information

NPI: 1376833509
Provider Name (Legal Business Name): RYAN PAUL TERLOUW M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 PATRIOT DR
MUSKEGON MI
49444-7807
US

IV. Provider business mailing address

1316 MERCY DR
MUSKEGON MI
49444-1835
US

V. Phone/Fax

Practice location:
  • Phone: 231-739-1933
  • Fax:
Mailing address:
  • Phone: 231-739-1930
  • Fax: 231-739-1953

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number4301112907
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: