| Terry P Detrich Md | |
|
545 Cynwood Dr Easton MD 21601-3864 | |
| (410) 820-5191 | |
| Not Available |
| Full Name | Terry P Detrich Md |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 545 Cynwood Dr, Easton, Maryland |
| Authorized Official Name and Position | Hugh Dawkins (DELEGATED OFFICIAL) |
| Authorized Official Contact | 4108226175 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Terry P Detrich Md 545 Cynwood Dr Easton MD 21601-3864 Ph: (410) 820-5191 | Terry P Detrich Md 545 Cynwood Dr Easton MD 21601-3864 Ph: (410) 820-5191 |
| NPI Number | 1306490610 |
|---|---|
| Provider Enumeration Date | 07/25/2019 |
| Last Update Date | 07/25/2019 |
| Medicare PECOS PAC ID | 7113256330 |
|---|---|
| Medicare Enrollment ID | O20190912001277 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306490610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Terry P Detrich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154433720 PECOS PAC ID: 2062670557 Enrollment ID: I20120301000438 |
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