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Individual

TERRENCE C REGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
21 HOSPITAL DR STE 140, PALM COAST, FL 32164
(386) 445-8530
(386) 446-5087
Mailing address
12109 COUNTY ROAD 103, OXFORD, FL 34484-2951
(523) 205-8981
(352) 391-6498

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
ME0073545
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
41513
BLUE SHIELD
Enumeration date
05/15/2006
Last updated
12/10/2020
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