Provider Demographics
NPI:1073678983
Name:PARGOT, TERRI L (DO)
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:L
Last Name:PARGOT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WOOD HILL RD
Mailing Address - Street 2:SUITE 313
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-8724
Mailing Address - Country:US
Mailing Address - Phone:301-838-4200
Mailing Address - Fax:301-610-8402
Practice Address - Street 1:200 WOOD HILL RD
Practice Address - Street 2:SUITE 313
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-8724
Practice Address - Country:US
Practice Address - Phone:301-838-4200
Practice Address - Fax:301-610-8402
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7918103T00000X
MDH00738362084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTF03471Medicare UPIN
MT000010831OtherBLUE CROSS BLUE SHEILD
MT0024174Medicaid
MT010001083Medicare ID - Type Unspecified