DR. TERRY DETRICH (NPI# 1154433720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154433720 |
| Entity Type | Individual |
| Full Name | DR. TERRY DETRICH |
| Credential | MD |
| Practice Address |
545 Cynwood Dr Easton MD 21601 |
| Mailing Address |
545 Cynwood Dr Easton MD 21601-3864 |
| Practice Telephone | 4108205191 |
| Practice Fax Number | 4108204997 |
| Mailing Telephone | 4108205191 |
| Mailing Fax Number | 4108204997 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-07-23 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
D12893 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 031581800 | 05 | |
| MD | BLUE SHIELD | 41274801 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 140 S Washington St, Easton, MD 216012912 | 4108226677 | 4108205717 |
| Street Address |
545 CYNWOOD DR |
| City | EASTON |
| State | MD |
| Zip Code | 21601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306490610 | Terry P Detrich Md | Psychiatry & Neurology | 545 Cynwood Dr, Easton, MD 21601-3864 | 2019-07-25 |
| 1467747444 | Mignonne Marie Lachapelle | Social Worker | 545 Cynwood Dr, Easton, MD 21601-3864 | 2011-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588205215 | Jodi Windsor Kindt | Nurse Practitioner | Aamg Talbot Primary Care, 28438 Marlboro Avenue, Easton, MD 21601 | 2019-10-03 |
| 1902466998 | Christina Deleon | Physician Assistant | 403 Marvel Court, Easton, MD 21601 | 2019-06-20 |
| 1710458583 | Patricia Vilani | Occupational Therapy Assistant | 12 Magnolia, Easton, MD 21601 | 2018-12-05 |
| 1538687702 | Kristin Dabbs Wilkerson | Counselor | 29520 Canvasback Drive, Easton, MD 21601 | 2017-09-07 |
| 1356869978 | Angela Lynn Rutherford | Physical Therapy Assistant | 610 Dutchman's Ln, Easton, MD 21601 | 2017-09-04 |
| 1851842389 | Myeyedr Optometry of Maryland, LLC | Optometrist | 28522 Marlboro Ave, Ste A, Easton, MD 21601 | 2016-10-19 |
| 1659721991 | Lauren Strady | Pediatrics | 500 Cadmus Ln Ste 210, Easton, MD 21601 | 2016-06-17 |
| 1194174391 | Statcare Group IIi, PC | Clinic/Center | 28522-c Marlboro Avenue, Easton, MD 21601 | 2016-06-08 |
| 1245684224 | Christina M Ball | Nurse Practitioner | 545 Cynwood Drive, Easton, MD 21601 | 2016-04-15 |
| 1205220274 | Rebecca Ann Ruby Ailstock | Midwife | 508 Idlewild Ave Ste 3, Easton, MD 21601 | 2015-03-26 |
| Find all providers in zip 21601 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619538865 | Unknown Azima Shaji | Psychiatry & Neurology | St. Luke's University and Health Network- Anderson, Medical Education Office- 1700, St. Luke's Blvd, Easton, PA 18045 | 2019-06-27 |
| 1629636790 | Catherine Rachel Craven | Psychiatry & Neurology | 1700 St Lukes Blvd Ofc, Easton, PA 18045-5670 | 2019-06-03 |
| 1033481718 | Terry P Detrich Md Pa | Psychiatry & Neurology | 140 S Washington St, Easton, MD 21601-2912 | 2012-01-27 |
| 1225659980 | Nora Ko | Psychiatry & Neurology | 1700 St Lukes Blvd, Easton, PA 18045-5670 | 2020-05-04 |
| 1811518954 | Cory Hackmyer | Psychiatry & Neurology | 1700 St Lukes Blvd Ofc, Easton, PA 18045-5670 | 2020-04-29 |
| 1316567779 | Seung Yun Kim | Psychiatry & Neurology | 1700 St Lukes Blvd, Easton, PA 18045-5670 | 2020-04-25 |
| 1912526690 | Jenifer Nicole Moceri | Psychiatry & Neurology | 1700 St Lukes Blvd, Easton, PA 18045-5670 | 2020-04-13 |
| 1306490610 | Terry P Detrich Md | Psychiatry & Neurology | 545 Cynwood Dr, Easton, MD 21601-3864 | 2019-07-25 |
| 1487213492 | Adriana Carola Mendez | Psychiatry & Neurology | St. Luke's University Health Network - Anderson, Medical Education Office 1700 St. St. Luke's Blvd, Easton, PA 18045-3592 | 2019-06-12 |
| 1124687918 | Naaima Mufti | Psychiatry & Neurology | 1700 St Lukes Blvd, Easton, PA 18045-5670 | 2019-06-06 |
| Find all providers in EASTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.