Individual
TERRY ANN DONOVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
6341 COOK AVE, STE A, CLEMMONS, NC 27012-9380
(336) 766-8400
(336) 766-8486
Mailing address
PO BOX 268, CLEMMONS, NC 27012-0268
(336) 766-8400
(336) 766-8486
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
203
NC
213ES0103X
Foot & Ankle Surgery Podiatrist
203
NC
213ES0131X
Foot Surgery Podiatrist
203
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
561696265
COMMERCIAL
—
05
—
8908053
—
NC
Enumeration date
06/09/2005
Last updated
06/01/2016
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