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NPI 1174773923

NPI 1174773923 : ANDREA L TERRY D.O. : NEW BERN, NC

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General NPI Number Information
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    NPI Number           |    1174773923
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREA L TERRY D.O.
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/29/2008
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    Last Update Date     |    03/17/2017
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Provider Practice Location Address
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    Address Line         |    2000 NEUSE BLVD # C 
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    City                 |    NEW BERN
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    State                |    NC
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    Zip                  |    28560-3449
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    Country              |    US
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    Telephone            |    252-633-8024
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    Fax                  |    252-633-8994
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Provider Business Mailing Address
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    Address Line         |    PO BOX 896206 
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    City                 |    CHARLOTTE
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    State                |    NC
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    Zip                  |    28289-6206
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    Country              |    US
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    Telephone            |    252-633-8024
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    Fax                  |    252-633-8994
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    208100000X
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    Taxonomy Name        |    Physical Medicine & Rehabilitation Physician
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    License Number       |    NC2010-00478
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    License Number State |    NC
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