Healthcare Provider Details

I. General information

NPI: 1487236980
Provider Name (Legal Business Name): TERRENCE ERROL ANTHONEY HENRY M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date: 02/24/2022
Reactivation Date: 08/29/2022

III. Provider practice location address

1 HOSPITAL DR STE CE306
COLUMBIA MO
65212-1000
US

IV. Provider business mailing address

2770 STANTONBURG ROAD APT 3C
GREENVILLE NC
27834
US

V. Phone/Fax

Practice location:
  • Phone: 573-882-7272
  • Fax:
Mailing address:
  • Phone: 252-327-5078
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: