Individual
TERENCE LEIGH WITHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7575 NORTHCLIFF AVE, SUITE 201, BROOKLYN, OH 44144-3267
(216) 661-4577
(216) 661-4784
Mailing address
7575 NORTHCLIFF AVE, SUITE 201, BROOKLYN, OH 44144-3267
(216) 661-4577
(216) 661-4784
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35-081587
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000241215
ANTHEM PIN
OH
05
—
0256582
—
OH
05
—
2350147
—
OH
01
—
260051953
RAILROAD MEDICARE PIN
OH
Enumeration date
12/19/2005
Last updated
08/21/2019
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