Provider Demographics
NPI:1053505461
Name:TERRYE A. MOWATT, M.D.
Entity Type:Organization
Organization Name:TERRYE A. MOWATT, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIST /DIRECTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERRYE
Authorized Official - Middle Name:ANN MARIE
Authorized Official - Last Name:MOWATT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-381-0060
Mailing Address - Street 1:8640 GUILFORD RD
Mailing Address - Street 2:SUITE 223
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21046-2655
Mailing Address - Country:US
Mailing Address - Phone:410-381-0060
Mailing Address - Fax:410-381-0090
Practice Address - Street 1:8640 GUILFORD RD
Practice Address - Street 2:SUITE 223
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-2655
Practice Address - Country:US
Practice Address - Phone:410-381-0060
Practice Address - Fax:410-381-0090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-29
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00538952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD=========OtherTIN