Individual
ROBERT EDWARD TERRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
15129
MS
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
15129
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117983
—
MS
Enumeration date
07/17/2006
Last updated
03/22/2017
Update your record
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