Individual
TERRY D ROLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2004032538
MO
2084N0400X
Neurology Physician
Primary
MD212800
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209425503
—
MO
05
—
500812704
—
OR
01
—
P00223849
RR MEDICARE
MO
01
—
P00415742
RAILROAD MEDICARE
MO
Enumeration date
05/01/2006
Last updated
01/05/2023
Update your record
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