# TERRY H EZELL

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1083788673
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 17708 | SC | Yes |
| 208800000X | Urology Physician | 95-00570 | NC | — |

## Other

- **Enumeration date:** 11/17/2006
- **Last updated:** 03/31/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0005525006 | AETNA | SC |
| 01 | — | 136H3 | BCBS OF NC | NC |
| 05 | — | 177089 | — | SC |
| 01 | — | 1905786 | UNITED HEALTHCARE | SC |
| 01 | — | 279866 | MAMSI | SC |
| 01 | — | 57365 | MEDCOST | SC |
| 01 | — | 760694 | GREAT WEST | SC |
| 05 | — | 89136H3 | — | NC |