Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | A126844 | CA |
Y | 208600000X | Surgeon | A126844 | CA |
N | 2082S0105X | Plastic Hand Surgeon | A126844 | CA |
NPI | 1750568168 |
---|---|
Provider Name | Dr. Michael James Terry |
First Address | San Francisco, CA 94143-0628 |
Second Address | San Francisco, CA 94143-0628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2008 |
Last Update Date | 13/08/2013 |