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Individual

MR. YUSEF U TERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2001 CRYSTAL SPRING AVE SW STE 201, ROANOKE, VA 24014-2465
(540) 853-0100
Mailing address
213 S JEFFERSON ST STE 1006, ROANOKE, VA 24011-1713

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110006995
VA
363A00000X
Physician Assistant
C5-0011868
DE
363A00000X
Physician Assistant
PA-2063
CA
363AS0400X
Surgical Physician Assistant

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PA2063
PA LICENSE
CA
Enumeration date
07/27/2009
Last updated
08/29/2024
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