Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101052267 | VA |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | D0047366 | MD |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD21307 | DC |
NPI | 1073673505 |
---|---|
Provider Name | Dr. Mark Howard Terris |
First Address | Rockville, MD 20852-4908 |
Second Address | Largo, MD 20774-5374 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2006 |
Last Update Date | 19/01/2022 |