Individual
MARILYN TERRANELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 JOHN ST, SUITE M020, KALAMAZOO, MI 49007-5341
(269) 657-4407
(269) 657-2550
Mailing address
601 JOHN ST, SUITE M020, KALAMAZOO, MI 49007-5341
(269) 657-4407
(269) 657-2550
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301037765
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1103958601
BCBS
—
01
—
1104840529
BCBSM - BRONSON
MI
05
—
1134188170
—
MI
05
—
4186831
—
MI
Enumeration date
03/20/2006
Last updated
10/14/2014
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