MEDICARE: TERRY ELLIOT PASSMAN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0802X	Addiction Psychiatry Physician	18468	AL

General Provider Information

NPI Number	:	1740287325
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRY ELLIOT PASSMAN MD

Provider Business Mailing Address
First Line	:	208 GREENO RD N STE D2
Second Line	:
City	:	FAIRHOPE
State	:	AL
Zip	:	36532-3057
Country	:	US
Telephone Number	:	251-928-4750
Fax Number	:	251-990-2560

Provider Business Practice Location Address
First Line	:	208 GREENO RD N STE D2
Second Line	:
City	:	FAIRHOPE
State	:	AL
Zip	:	36532-3057
Country	:	US
Telephone Number	:	251-928-4750
Fax Number	:	251-990-2560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2005
Last Update Date	:	05/19/2022

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