Individual
TERENCE BERTELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12070 OLD LINE CTR, STE 303, WALDORF, MD 20602-2513
(301) 645-5100
(301) 645-3695
Mailing address
12070 OLD LINE CTR, STE 303, WALDORF, MD 20602-2513
(301) 645-5100
(301) 645-3695
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
101031774
VA
207RC0000X
Cardiovascular Disease Physician
Primary
D0030041
MD
207RC0000X
Cardiovascular Disease Physician
MD12286
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410942-01
BCBS
MD
05
—
491041900
—
MD
Enumeration date
11/04/2005
Last updated
02/22/2016
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