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Individual

RAYMOND C TERVO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3900 WASHINGTON AVE STE 100, EVANSVILLE, IN 47714
(812) 485-6694
Mailing address
PO BOX 13059, BELFAST, ME 04915-4021

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
01077656A
IN
208000000X
Pediatrics Physician
40431
MN
2080P0008X
Pediatric Neurodevelopmental Disabilities Physician
Primary
01077656A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
931227700
MN
Enumeration date
10/18/2006
Last updated
08/13/2018
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