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General NPI Number Information
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NPI Number | 1790908861
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Entity Type | Individual
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Provider Name | JAMES CLEMENT TERRIAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 14150 COUNTY ROAD 428
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City | NEWBERRY
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State | MI
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Zip | 49868-7762
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Country | US
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Telephone | 906-293-1310
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Fax |
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Provider Business Mailing Address
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Address Line | 14344 S COOPER ST
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City | NEWBERRY
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State | MI
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Zip | 49868-1920
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Country | US
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Telephone | 906-293-5756
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Fax |
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 4301030101
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License Number State | MI
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