Individual
DR. ILENE SH TERRELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
12010 KILARNEY DR, FREDERICKSBURG, VA 22407
(540) 548-3668
(540) 548-0019
Mailing address
12010 KILARNEY DR, FREDERICKSBURG, VA 22407
(540) 548-3668
(540) 548-0019
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0103000702
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09302417
—
VA
01
—
214528
ANTHEM
—
01
—
528738
ALLIANCE
—
01
—
5413632891
COM HEALTH-OPTIMA HLTHPPO
—
01
—
5413633289
GEHA
—
Enumeration date
12/13/2005
Last updated
10/22/2007
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