Terry P Detrich Md | |
545 Cynwood Dr Easton MD 21601-3864 | |
(410) 820-5191 | |
Not Available |
Full Name | Terry P Detrich Md |
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Speciality | Psychiatry & Neurology |
Location | 545 Cynwood Dr, Easton, Maryland |
Authorized Official Name and Position | Hugh Dawkins (DELEGATED OFFICIAL) |
Authorized Official Contact | 4108226175 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Terry P Detrich Md 545 Cynwood Dr Easton MD 21601-3864 Ph: (410) 820-5191 | Terry P Detrich Md 545 Cynwood Dr Easton MD 21601-3864 Ph: (410) 820-5191 |
NPI Number | 1306490610 |
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Provider Enumeration Date | 07/25/2019 |
Last Update Date | 07/25/2019 |
Medicare PECOS PAC ID | 7113256330 |
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Medicare Enrollment ID | O20190912001277 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306490610 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
Provider Name | Terry P Detrich |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1154433720 PECOS PAC ID: 2062670557 Enrollment ID: I20120301000438 |
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