Individual
DR. TERRY DETRICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
29466 PINTAIL DR STE 10, EASTON, MD 21601-9324
(443) 746-3816
(410) 604-7349
Mailing address
29466 PINTAIL DR STE 10, EASTON, MD 21601-9324
(443) 746-3816
(410) 604-7349
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
D12893
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41274801
BLUE SHIELD
MD
Enumeration date
08/31/2006
Last updated
04/22/2024
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