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NPI Code Detail

MEDICARE: ANDREA R. TERRELL PH.D.

MEDICARE:   ANDREA R. TERRELL  PH.D.
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
1247ZC0005XClinical Laboratory Director (Non-physician)

General Provider Information

NPI Number : 1962719229
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREA R. TERRELL PH.D.
Provider Business Mailing Address
First Line : 2265 EXECUTIVE DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46241-4352
Country : US
Telephone Number : 317-243-3894
Fax Number :
Provider Business Practice Location Address
First Line : 2265 EXECUTIVE DR
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46241-4352
Country : US
Telephone Number : 317-243-3894
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2010
Last Update Date : 03/18/2015

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Directions to “ ANDREA R. TERRELL PH.D.” Practice Location

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