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Individual

PETER JOHN TERRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
11855 ULYSSES ST NE, BLAINE, MN 55434-3947
(763) 785-4200
(763) 785-8419
Mailing address
11855 ULYSSES ST NE, BLAINE, MN 55434-3947
(763) 785-4200
(763) 785-8419

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47287
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
556T0TE
BLUE CROSS BLUE SHIELD
MN
Enumeration date
07/19/2006
Last updated
08/22/2023
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